Dr. Victoria Sampson Links Oral Microbiome Dysbiosis to Major Systemic Diseases

Victoria Sampson 博士揭示口腔微生物群失调与重大全身性疾病的关联 口腔致病菌直接推动了从心脏病、阿尔茨海默病到勃起功能障碍和不孕不育等一系列全身性疾病。 Victoria Sampson 博士探讨了口腔微生物群如何作为全身健康的关键门户，直接影响心血管疾病、类风湿性关节炎、阿尔茨海默病、勃起功能障碍和生育能力等状况。她解释了饮食的进化演变如何改变人类的颌骨结构以及现代疾病的易感性，并强调了相关性与直接细菌因果关系之间的区别。通过个人轶事、临床案例分析以及对主持人 Steven Bartlett 唾液检测结果的现场解读，她详细介绍了平衡口腔菌群和减轻全身炎症的可行策略，包括正确的刷牙技巧、饮用绿茶的益处，以及刷牙后避免立即漱口等实用建议。 口腔微生物群包含约700种、共计约20亿个细菌，是通向机体全身健康的门户。 (2:02) 世界卫生组织的数据显示，全球有35亿人患有口腔疾病，其中重度牙周炎波及全球10%的人口。 (2:02) 开创性研究将较差的口腔卫生和牙龈疾病与严重的 COVID-19 并发症及致命的继发性细菌重叠感染联系起来。 (8:33) 工业化、质地松软的加工饮食经过几代人的演变改变了颌骨发育，导致结构性牙齿拥挤和普遍的智齿阻生。 (13:55) 未加治疗的牙周炎会诱发慢性全身性炎症，加剧类风湿性关节炎等严重的自身免疫性疾病。 (28:18)

Dentist and researcher Dr. Victoria Sampson argues that the oral microbiome serves as a vital gateway to systemic health, demonstrating that oral dysbiosis actively drives cardiovascular disease, neurodegeneration, infertility, and chronic inflammation. Integrating saliva diagnostics into routine medicine allows clinicians to detect and mitigate multi-organ pathologies before irreversible damage occurs. Mechanisms Connecting Oral Dysbiosis to Cardiovascular Damage (30:35) Dr. Sampson explains that the oral cavity harbors roughly two billion bacteria across 700 species, representing the body's second-largest microbial community. When dysbiosis occurs, bleeding gums become active open wounds that permit oral bacteria and toxic enzymes to enter the bloodstream. This translocation impairs the vascular system's ability to dilate and constrict. Consequently, gum disease is associated with a 20% higher probability of high blood pressure, while individuals with periodontitis face double the risk of a heart attack and triple the risk of a stroke. In hospital settings, 30% to 40% of cardiac cases involving damaged heart valves are directly traceable to oral bacteria causing infective endocarditis. Systemic inflammation compounds these cardiovascular and respiratory hazards. During acute viral illnesses like COVID-19, Dr. Sampson's research indicated that patients with gum disease were nine times more likely to experience severe complications, primarily dying from secondary oral-bacterial lung super-infections rather than the virus itself. Chronic periodontitis continuously releases inflammatory markers like C-reactive protein (CRP) into circulation, exacerbating systemic immune cascades. Systemic Links to Neurodegeneration, Autoimmunity, and Oncology (44:02) Long-term periodontal disease exerts severe downstream effects on cognitive and autoimmune health. A 20-year longitudinal study of 20,000 individuals showed that suffering from gum disease for more than a decade increases Alzheimer's risk by 70%. Mechanistically, the pathogen Porphyromonas gingivalis crosses the blood-brain barrier to secrete toxic gingipain enzymes that destroy neurons; these enzymes were detected in 97% of post-mortem Alzheimer's brain samples compared to 0% of healthy controls. Similarly, Dr. Sampson notes an eightfold increase in gum disease risk among rheumatoid arthritis patients, where aggressively treating periodontitis reduced circulating inflammatory markers enough to restore patient mobility. Oncological research also highlights the consequences of oral bacterial translocation. The bacterium Fusobacterium nucleatum appears in elevated concentrations within breast cancer tissue and in over 50% of colorectal tumors, where it accelerates tumor proliferation and increases therapy resistance. While Dr. Sampson stops short of asserting sole causation for cancer, she identifies bacterial overgrowth as a significant risk factor, noting that green tea demonstrates selective antibacterial properties against F. nucleatum. Influences on Fertility, Development, and Vascular Function (62:35) Oral pathogens significantly impair reproductive and vascular function. A study evaluating subfertile men found that over 90% suffered from underlying oral infections; treating these issues improved sperm quality by 20% and increased pregnancy success rates by 70%. In women, untreated gum disease delays conception by an average of two months, whereas a 10,000-woman trial in Malawi showed that chewing sugar-free xylitol gum reduced preterm births by 20% by boosting protective saliva. Furthermore, vascular inhibition from periodontal toxins raises the risk of erectile dysfunction by 2.85 times by preventing proper blood vessel dilation. Dr. Sampson traces modern structural oral issues to evolutionary dietary shifts. Citing Weston A. Price, she explains that soft, processed foods fail to provide the chewing forces necessary for childhood jaw expansion, resulting in narrow dental arches, crowded teeth, and impacted wisdom teeth. These structural deficits frequently induce chronic mouth breathing, which bypasses nasal filtration, alters the oral microbiome, and is associated with a 50% to 90% higher risk of ADHD-like symptoms in children with sleep-disordered breathing. Evidence-Based Oral Care and Diagnostic Saliva Screening (76:35) To maintain oral barrier integrity, Dr. Sampson advises correcting widespread hygiene mistakes. Individuals should wait at least 30 minutes after consuming sugar or acidic drinks before brushing to avoid scrubbing demineralizing acid into enamel, and should spit out toothpaste without rinsing with water to preserve protective active ingredients. Because the average person brushes for only 20 to 30 seconds rather than the recommended two minutes, electric toothbrushes with pressure sensors help prevent abrasive gum recession, especially when cleaning hard-to-reach inner lower molars at a 90-degree angle. Dr. Sampson cautions against abrasive over-the-counter whitening toothpastes that permanently strip enamel, and notes that smoking constricts oral blood vessels, masking underlying periodontal destruction by preventing bleeding gums. She advocates for personalized saliva testing to identify pathogenic bacterial strains, collagen-degrading enzymes (aMMP-8), and genetic predispositions, allowing clinicians to tailor preventative regimens before systemic damage develops. Dr. Sampson advocates for reintegrating dentistry into systemic medicine through non-invasive saliva profiling, which provides early diagnostic indicators similar to blood testing. Although multifactorial conditions like cancer and neurodegeneration involve complex lifestyle and genetic confounders, optimizing the oral microbiome presents an immediate, compounding opportunity to reduce systemic inflammation and chronic disease.

牙医维多利亚·桑普森博士（Dr. Victoria Sampson）指出，口腔微生态绝非孤立的局部系统，其菌群失调引发的慢性炎症与细菌易位是诱发心血管疾病、阿尔茨海默病、关节炎及不孕不育等全身性重大病理改变的核心驱动力之一。她呼吁打破传统牙科与临床医学的学科壁垒，利用唾液诊断与精准微生物管理，将口腔健康置于全身预防医学的前沿。 菌群易位与系统性炎症的病理机制 (2:02) 人类口腔是体内第二大微生物群落，寄生着约700种、总计超20亿个细菌，且牙齿是人体唯一不发生脱落更新的硬组织表面。桑普森博士指出，口腔微生态影响全身健康的机制主要包括细菌直接易位、慢性低度炎症以及血管内皮功能损伤。当牙周屏障破损（表现为牙龈出血）时，病原微生物及其分泌的毒性酶会侵入血液循环，削弱血管正常的舒张与收缩能力，并持续释放炎症介质，使C反应蛋白（CRP）升高。 在急性感染或免疫过载情境下，这种失衡尤为危险。桑普森博士在《英国牙科杂志》（British Dental Journal）发表的研究表明，患有牙周病的重症COVID-19患者出现并发症的概率高出9倍，主要死因并非病毒本身，而是口腔病原菌向肺部迁移引发的继发性细菌二重感染。类似地，心脏瓣膜术后患者在6个月内被严格禁止洗牙，原因在于侵入性操作可能使口腔细菌涌入血液，吸附于受损瓣膜形成致命的感染性心内膜炎（医院内30%至40%的心脏瓣膜病例可追溯至口腔菌）。 牙周病与全身重大慢性疾病的关联 (30:35) 临床证据显示，口腔菌群失衡与多种远端器官病变存在高度相关甚至直接因果链条。在心脑血管领域，牙周病使高血压患病风险上升20%，心脏病发作风险增加2倍，中风风险增加3倍。由于牙周细菌毒素阻碍血管平滑肌舒张，患有牙周炎的男性出现勃起功能障碍（ED）的风险增加2.85倍。在神经退行性疾病方面，一项涉及2万人的20年纵向研究发现，牙周病史超10年者患阿尔茨海默病的风险增加70%；研究证实牙龈卟啉单胞菌（P. gingivalis）能跨越血脑屏障并分泌破坏神经元的牙龈蛋白酶（gingipains）——尸检发现97%的阿尔茨海默病患者脑组织存在该酶，而健康对照组为0%。 此外，在肿瘤与自身免疫疾病中，研究发现超50%的结直肠癌组织及乳腺癌病灶中高浓度富集具核梭杆菌（Fusobacterium nucleatum），该菌可加速小鼠肿瘤生长，而绿茶提取物被证实能有效抑制该菌。在类风湿性关节炎患者中，牙周炎患病率高达正常人群的8倍，针对性牙周抗炎治疗可显著降低患者的全身炎症反应，甚至帮助患者戒除激素并恢复行走能力。在生殖健康领域，超90%生育受阻的男性患有牙科疾病，经治疗后其伴侣妊娠成功率提升70%；针对马拉维10,000名孕妇的临床试验显示，仅通过咀嚼无糖木糖醇口香糖促进唾液冲洗抑菌，早产率便下降了20%。 饮食软化与呼吸方式改变面部发育 (13:55) 现代人高发的错颌畸形与牙周隐患源于饮食演化带来的生物力学退化。桑普森博士援引20世纪牙医韦斯顿·A·普莱斯（Weston A. Price）的跨人群对比研究指出，食用未经加工的粗硬高纤维饮食的原住民颌骨宽大、牙列整齐且无龋齿；而摄入工业化精细软食的人群普遍出现颌骨发育不足。现代人类牙齿的绝对尺寸并未随演化减小，儿童咀嚼机械刺激不足导致上下颌骨发育受限，直接催生了普遍的牙齿拥挤、正畸需求以及阻生智齿。 颌骨发育不全进一步加剧了儿童口呼吸现象。与具有加温、湿润和黏膜过滤功能的鼻呼吸不同，长期口呼吸绕过了防御屏障，直接破坏口腔微生态平衡并导致慢性干燥。一项追踪11,000名儿童长达6年的研究证实，伴有睡眠呼吸障碍（如口呼吸）的儿童表现出类ADHD（注意缺陷多动障碍）症状的风险比鼻呼吸儿童高出50%至90%，这与长期缺乏过滤充足氧气供应大脑密切相关。 唾液精准检测与循证日常护理规范 (76:35) 针对口腔微生态的干预正从被动填补转向精准数据监测。桑普森博士指出，唾液检测不仅能识别包括牙龈卟啉单胞菌在内的高危病原菌群，还能通过监测基质金属蛋白酶-8（aMMP-8）在牙龈软组织塌陷前预警胶原分解；同时，人体有10种基因突变会改变唾液pH值、甜味敏感度及促炎反应，导致不同个体即使菌群相似也会产生截然不同的发病进程。此外，微生态在亲密接触中具有传染性，伴侣每天接吻11次以上会导致口腔菌群高度趋同，且长吻可转移60%至70%的益生菌，甚至口交亦可能造成尿道菌群向口腔转移并引发顽固性牙龈炎。 在日常预防层面，桑普森博士纠正了诸多常见误区：首先，摄入酸性饮料或甜食后严禁立即刷牙，否则会将酸性物质磨入被软化的牙釉质中，必须等待至少30分钟，期间可通过咀嚼无糖口香糖刺激唾液中和酸碱度；其次，刷牙后应“吐出泡沫而不漱水”，保留有效防护层；再次，使用电动牙刷时，外侧面应呈30度角对准牙龈边缘打圈，最易遗漏的下颌后磨牙舌侧面则需以90度角仔细清洁；最后，切勿滥用高磨损性美白牙膏以免不可逆地磨损牙釉质露出黄色牙本质，吸烟者因尼古丁收缩血管常无出血表象，极易掩盖深层进行性骨质破坏。 桑普森博士主张将牙科重新融入系统性全科医学，使常规唾液筛查成为与验血并行的早期全身疾病预警工具。尽管阿尔茨海默病与肿瘤等多因素疾病的绝对因果关系仍待进一步前瞻性论证，但现有临床证据已证实，通过细微、科学的日常口腔护理降低菌负荷与炎症渗漏，能够产生多系统的长期健康复利。

## Background 本期内容由知名播客频道 The Diary Of A CEO 于 2024 年 11 月 11 日在 YouTube 平台发布。节目邀请了功能性牙医、研究学者兼 The Health Society Labs 创始人 Victoria Sampson 医生，围绕口腔微生态与全身系统性疾病的深层联系展开深入探讨。 ## TL;DR 访谈全面揭示了口腔微生态作为人体第二大微生物组对整体健康的决定性影响。Sampson 医生结合临床数据与前沿科研，详述了牙周病及口腔有害菌群如何跨越屏障，直接诱发或加剧阿尔茨海默病、心血管疾病、类风湿性关节炎、勃起功能障碍、男女生育受阻乃至癌症等系统性病变。对话还针对口呼吸、日常饮食中的糖分模式、刷牙误区（如刷牙后立刻漱口）进行了科学纠偏，并呼吁医疗界打破学科孤岛，将无创唾液检测与口腔微生态管理作为预防全身疾病的前哨站。 ## Atmosphere & style 对谈节奏紧凑而兼具专业严谨与生动幽默，主持人 Steven Bartlett 带着强烈的好奇心不断追问底层机制，而 Sampson 医生的解答通俗犀利且充满科学说服力。在现场解读主持人个人唾液报告与基因倾向时，两人互动松弛风趣，穿插着如因亲吻爱犬导致口臭等戏剧性临床轶事，极大地消解了硬核医学话题的枯燥感。整期节目传递出强烈的颠覆感与行动力，既发人深省又极具实操指导价值，让听众在震撼之余重新审视日常口腔护理带来的深远健康复利。 ## Bulletin - [02:01](https://www.youtube.com/watch?v=p3fSwd1cF08&t=121s) 口腔微生态是人体第二大微生物组，包含约700种、20亿个细菌，且牙齿是全身唯一不脱落的硬表面，无法自我剥离细菌，导致牙周病成为全球35亿人口腔危机的根源并直接驱动全身慢性低度炎症。 - [44:12](https://www.youtube.com/watch?v=p3fSwd1cF08&t=2652s) 口腔致病菌与多系统重大疾病具备直接因果关联：牙龈卟啉单胞菌分泌的牙龈蛋白酶可穿透血脑屏障破坏神经元，患慢性牙龈疾病超10年人群罹患阿尔茨海默病风险提升70%；牙周病男性勃起功能障碍风险高出2.85倍。 - [01:02:35](https://www.youtube.com/watch?v=p3fSwd1cF08&t=3755s) 清除男性口腔感染6至8个月后受孕率提升70%，患牙周病女性受孕周期平均多耗费2个月；马拉维大型试验证明咀嚼含木糖醇无糖口香糖可降低孕妇20%早产发生率。 - [01:16:00](https://www.youtube.com/watch?v=p3fSwd1cF08&t=4560s) 日常护齿核心法则是刷牙后“只吐不漱口”以留存有效屏障、进食酸糖后严禁立刻刷牙以防牙釉质磨损，以及利用吸管旁路效应减少酸糖及色素对牙体的直接侵蚀。 ## Key takeaways - [00:00](https://www.youtube.com/watch?v=p3fSwd1cF08&t=0s) 口腔是全身健康的前门：超过90%的全身疾病可追溯至微生态失衡，口腔疾病与心血管病、阿尔茨海默病、类风湿关节炎及生殖障碍存在确凿病理联系。 - [10:46](https://www.youtube.com/watch?v=p3fSwd1cF08&t=646s) 牙周病患者罹患新冠重症并发症概率高出9倍，主要由牙周持续释放的炎性因子诱发细胞因子风暴，以及口腔有害菌下行肺部引发继发性细菌超级感染所致。 - [13:55](https://www.youtube.com/watch?v=p3fSwd1cF08&t=835s) 现代加工食品导致人类颌骨发育不足与牙弓狭窄，使恒牙萌出缺乏空间，这是导致现代人牙列拥挤和阻生智齿频发的根本演化诱因。 - [22:58](https://www.youtube.com/watch?v=p3fSwd1cF08&t=1378s) 牙齿是全身唯一不发生生理代谢脱落的硬表面，必须依赖物理机械手段清理生物膜；遗传突变亦会导致部分人群在极高卫生自律下依然出现过度破坏性免疫炎症。 - [27:36](https://www.youtube.com/watch?v=p3fSwd1cF08&t=1656s) 牙龈出血绝非正常现象，表明牙周屏障破损且毒性酶正侵蚀血管内皮；类风湿关节炎患者患牙周病风险高出8倍，二者存在显著的双向因果恶化机制。 - [30:43](https://www.youtube.com/watch?v=p3fSwd1cF08&t=1843s) 口腔致病菌进入血液后易吸附于粗糙受损的心脏瓣膜，临床住院心瓣膜感染中高达30%至40%可追溯至口腔菌群，且牙周病使高血压风险提升20%。 - [36:54](https://www.youtube.com/watch?v=p3fSwd1cF08&t=2214s) 具核梭杆菌在乳腺癌患者组织及超50%结直肠癌肿瘤中被高频检出，动物实验证实其可加速肿瘤生长并提升侵袭性，而绿茶具备针对该菌的天然抗菌活性。 - [41:10](https://www.youtube.com/watch?v=p3fSwd1cF08&t=2470s) 长时间缓慢啜饮含糖热饮会令唾液中和机制彻底瘫痪，引发严重酸蚀脱矿，摄入糖分应采取“集中突击”单次快速解决原则。 - [44:12](https://www.youtube.com/watch?v=p3fSwd1cF08&t=2652s) 牙龈卟啉单胞菌释放的毒性牙龈蛋白酶在阿尔茨海默病患者脑组织中检出率高达97%，而在健康对照组中为0%，构成了不可逆脑损伤的关键可控风险因子。 - [52:18](https://www.youtube.com/watch?v=p3fSwd1cF08&t=3138s) 剧烈心理创伤与慢性压力会引发唾液骤减并激增aMMP-8酶活性，在肉眼可见病变发生前即可引爆牙周胶原蛋白的大规模不可逆破坏。 - [55:59](https://www.youtube.com/watch?v=p3fSwd1cF08&t=3359s) 长期口呼吸绕过了鼻腔的温湿过滤与净化系统，导致夜间轻度缺氧，使儿童表现出ADHD样症状的几率较正常鼻呼吸儿童高出50%至90%。 - [58:22](https://www.youtube.com/watch?v=p3fSwd1cF08&t=3502s) 深吻与口交等亲密行为可直接转移双方口腔菌群或泌尿生殖道病原体，引发顽固性牙龈非典型炎症；长期共处伴侣的口腔菌谱会表现出高度趋同。 - [01:02:35](https://www.youtube.com/watch?v=p3fSwd1cF08&t=3755s) 超过90%生育力低下的男性存在未治愈口腔感染，彻底清除病灶后精子活力改善20%，伴侣受孕成功率提升70%；患牙周病女性受孕则平均延迟2个月。 - [01:16:00](https://www.youtube.com/watch?v=p3fSwd1cF08&t=4560s) 刷牙后务必“吐出多余泡沫，切忌清水漱口”，否则会冲洗掉牙膏中的保护性有效成分；进食酸糖后应等待30分钟待牙釉质再矿化后再刷牙。 - [01:18:15](https://www.youtube.com/watch?v=p3fSwd1cF08&t=4695s) 大众平均刷牙时长仅20至30秒，使用具备压力感应与计时的电动牙刷更安全，且清洁下后牙内侧盲区时需抬高手肘以近90度角垂直伸入。 - [01:21:59](https://www.youtube.com/watch?v=p3fSwd1cF08&t=4919s) 市售强研磨美白牙膏会磨损无法再生的牙釉质，使下方偏黄牙本质裸露反而加剧发黄与敏感；安全美白必须依托牙医处方与温和系统。 - [01:26:08](https://www.youtube.com/watch?v=p3fSwd1cF08&t=5168s) 吸烟与电子烟诱发口干症且尼古丁导致微血管剧烈收缩，制造出“牙龈不出血”的假性健康表象，实则掩盖了牙槽骨正处于无声破坏的崩解期。 - [01:30:18](https://www.youtube.com/watch?v=p3fSwd1cF08&t=5418s) 未来的现代整合医学应将口腔微生态纳入全身常规体检，通过无创唾液分子检测建立对心血管、代谢及自身免疫性疾病的早期预警与转诊闭环。 ## Detailed walkthrough ### [00:00](https://www.youtube.com/watch?v=p3fSwd1cF08&t=0s) 口腔微生态与全身健康的惊人联系 对话在一组令人震撼的研究发现中展开：口腔健康与生育能力之间存在直接关联。最新研究表明，在无法与伴侣自然受孕的男性中，超过 90% 患有某种口腔疾病；而当这些口腔疾病得到有效治疗后，伴侣的受孕成功率竟然提升了 70%。对女性而言，牙周病（gum disease）同样会带来负面影响，患有牙周病的女性平均需要多花两个月才能成功受孕。然而，面对如此关键的医学发现，公众和学界对此的讨论却少之又少。自称 "唾液女王"（the saliva queen）的 Victoria Sampson 医生，正致力于打破这一沉默。 ```mermaid flowchart TD accTitle: 口腔微生态失衡对全身系统的潜在危害 accDescr: 展示口腔微生物菌群失调如何直接影响生育、心血管、脑部及自身免疫等全身健康。 A["口腔微生态失衡<br/>(Oral Microbiome Dysbiosis)"] --> B["生殖健康受损<br/>男性不育风险增加 / 女性受孕周期延长 / 勃起功能障碍风险提升2.85倍"] A --> C["心脑血管与代谢疾病<br/>高血压 / 心脏病 / 糖尿病"] A --> D["神经退行性疾病<br/>阿尔茨海默病 (Alzheimer's)"] A --> E["自身免疫与炎症反应<br/>类风湿关节炎 (Rheumatoid Arthritis)"] A --> F["肿瘤侵袭性提升<br/>特定细菌使癌细胞更难治疗"] ``` 现代医学数据进一步表明，人体超过 90% 的疾病都可以追溯到微生物组（microbiome）。一旦口腔微生态发生失衡，一系列重大全身性疾病的发生风险都会显著增加，包括高血压、心脏病、阿尔茨海默病（Alzheimer's）以及类风湿关节炎；患有牙周疾病的男性，其勃起功能障碍（erectile dysfunction）的患病几率是健康人群的 2.85 倍。此外，最新的肿瘤学研究还发现，口腔内的特定致病细菌能够让癌症变得更具侵袭性，导致治疗难度大幅上升。 导致微生态崩溃的核心诱因主要包括：不良的口腔卫生习惯、糖分摄入、长期精神压力，以及某些先天基因突变。但令人振奋的是，这一过程具有高度可逆性。Sampson 医生分享了一个典型临床案例：一位患有严重类风湿关节炎且伴随严重牙周病的女性患者，在 Sampson 医生为其系统治疗牙周病后，其关节炎症状得到了戏剧性的改善，最终甚至能够重新独立行走。 - 超过 90% 无法受孕的男性存在未诊断或未治愈的口腔疾病，治疗后受孕率提升 70%。 - 女性患有牙周病会导致受孕延迟约 2 个月。 - 患有牙周病的男性发生勃起功能障碍的风险高出 2.85 倍（2.85 times more likely）。 --- ### [02:01](https://www.youtube.com/watch?v=p3fSwd1cF08&t=121s) 什么是口腔微生态？为何它至关重要 在正式探讨专业细节前，主持人 Steven Bartlett 插入了一段例行呼吁：统计显示，频道有高达 53% 的常态听众尚未点击订阅，他恳请观众通过订阅支持团队，以产出更多优质深度访谈。随后，话题转回 Sampson 医生的核心使命——向大众证明“口腔是通往全身的大门”（the mouth is the gateway to the rest of the body）；想要获得真正的全身健康，第一步必须从口腔抓起。 过去十年间，公众对肠道微生态（gut microbiome）的认知已深入人心，人们熟知通过调整饮食、摄入益生菌（probiotics）和益生元（prebiotics）来维护肠道。但极少有人意识到：口腔微生态是仅次于肠道的**人体第二大、且最多样化的微生物组**。与肠道相比，口腔微生态不仅更容易被外界干预和调整，其对全身健康产生的冲击也更直接。 - 口腔微生态由约 700 种不同细菌构成，细菌总数高达 20 亿（2 billion bacteria）。 - 口腔内部并非单一环境，而是包含了多种截然不同的微生态小生境（niches）：牙龈下深处、咽喉后壁、牙齿光滑表面等，各自具有不同的温度、湿度、含氧量和酸碱度，生存着形态各异的细菌群落。 - 人体的每一个微小动作——吞咽、呼吸、饮水、进食乃至接吻，都会重塑口腔细菌结构；而每一次吞咽或吸气，口腔中的病原体便会顺势下行进入消化道或呼吸系统，扩散到身体其他器官并引发生理损害。 --- ### [04:37](https://www.youtube.com/watch?v=p3fSwd1cF08&t=277s) 全球口腔健康危机与代际认知的转变 日常行为与微生态交换密切相关。Sampson 医生引述了一项有趣的接吻研究：伴侣之间每天需要接吻超过 11 次，两人的口腔菌群才会出现高度同质化（共享相同的微生物群谱）。除了亲密接触，个人的日常生活习惯和周围的空气质量，同样时刻左右着口腔内特定优势菌群的生存与繁衍。 口腔疾病在全球范围内已演变为极其严峻的流行病学危机： - 世界卫生组织（WHO）数据显示，全球有高达 35 亿人（3.5 billion people）患有某种形式的口腔疾病。 - 全球约有 10% 的人口饱受重度牙周病的折磨，使其成为全人类发生率最高的慢性全身炎症性疾病之一。 回想早年的职业生涯，Sampson 医生感慨万千。过去她痴迷于口腔微生态研究时，常被同行、甚至患者视为不切实际的“空想家”（a dreamer），大家普遍认为口腔问题不过是几颗牙齿的修修补补，无伤大雅。然而近一两年间，公众观念发生了剧烈转向：世界各地的患者纷纷慕名专程飞来，只为了接受一次口腔微生态测试，以全面剖析自身体内潜藏的病理线索。这种转变归功于年轻一代对可量化健康数据（wearables、睡眠追踪、饮食记录）的强烈追求。患者不再满足于传统牙科医患间被动的“盲目信任”，而是渴望清晰掌握自己口腔内的菌群数据、炎症水平以及未来的患病风险。 更重要的是，医学研究在近五年完成了重大飞跃：过去科学界常将牙周炎与心脏病、糖尿病的关系视为“相关性”（correlation）——归咎于吸烟、不良饮食等共同危险因素；而最新的分子生物学证据已经确凿证实，口腔微生态失衡与多项重大全身性疾病之间存在切实的**因果关联**（causation）。 --- ### [07:47](https://www.youtube.com/watch?v=p3fSwd1cF08&t=467s) “唾液女王”的职业缘起与卡罗林斯卡学院的启蒙 谈及个人履历，Victoria Sampson 医生笑称自己不仅是牙医，同行和患者间更是送了她一个绰号——“街头唾液女王”（the saliva queen on the streets）。 在接受了长达六年的传统牙医学正规训练后，她最初与普通牙医无异，按部就班地进行补牙、拔牙等常规操作。然而，大学期间在瑞典卡罗林斯卡学院（Karolinska Institute）的交流经历彻底改变了她的专业轨迹。卡罗林斯卡学院作为全球顶尖的牙科医学学府，其核心教学理念始终围绕着“口腔与身体的系统联系”（mouth-body connection）以及“唾液分子检测”。那里的教授曾向她提出一个直击灵魂的问题： > “你去看内科医生，他们会为你验血；那为什么你去看牙医，牙医却不为你化验唾液呢？” 这颗关于“唾液作为全身健康诊断窗口”的种子自此深埋在她心底。毕业初期，她一边在英国国家医疗服务体系（NHS）公立医院任职，一边在私立诊所执业。随着对传统牙科局限性的反思与临床经验的累积，她开始全力投入功能性口腔医学与微生态科研，探索口腔微环境与全身系统性疾病之间更深层次的纽带。 ### [08:59](https://www.youtube.com/watch?v=p3fSwd1cF08&t=539s) 疫情期间的科研突破与口腔微生物检测的诞生 在完全转向私人执业后不久，新冠疫情暴发，英国各地的牙科诊所全部被勒令停业。维多利亚·桑普森医生（Dr Victoria Sampson）对此感到难以置信——政府的政令实质上是将牙科视作一种“非必需品”。面对这种匪夷所思的局面，她决定投身科学研究，并撰写了一篇探讨口腔健康与新冠重症并发症之间关联的学术论文。研究的初步发现令人震惊：口腔健康状况较差或患有牙周病的患者，罹患新冠并发症的风险显著升高。 随后，这项研究进一步拓展为她与多家大学和医院的科研合作。然而当时面临的一大棘手难题是：由于感染控制规定，牙医无法直接进入病房为新冠患者检查牙齿和牙龈。研究团队另辟蹊径，改为收集患者的唾液样本送入实验室分析。令人惊喜的是，仅凭一管唾液，他们便获得了患者口腔实时微生态环境的极佳“快照”。数据最终揭示，患有牙周病的新冠患者出现严重并发症的概率竟是常人的整整 9 倍。这一突破让桑普森医生深受触动：肠道有微生态检测，泌尿道有微生态检测，几乎人体每个菌群都有相应的检测手段，为什么唯独口腔微生物群被彻底忽视？借由这次契机，她在欧洲研发出了首批商业化口腔微生物检测工具之一，并在近期推出了升级版检测产品。 ### [10:46](https://www.youtube.com/watch?v=p3fSwd1cF08&t=646s) 口腔健康如何左右生死：细胞因子风暴与细菌超级感染 主持人史蒂芬·巴特利特（Steven Bartlett）提到，桑普森医生发表在权威学术期刊《英国牙科杂志》（British Dental Journal, BDJ）上的那篇论文——《口腔卫生与新冠感染严重程度之间是否存在联系？》（*Could there be a link between oral hygiene and severity of SARS-CoV-2 infections?*），不仅是世界上第一篇论证牙周病加重新冠重症的科研论文，更是该刊物有史以来被引用和阅读最多的文章之一。甚至世界卫生组织（WHO）和英国紧急情况科学咨询小组（SAGE）也正是注意到了这项研究，才意识到口腔健康对全身健康的不可替代性，并最终促成了全英牙科诊所的重新开放。史蒂芬随即向她发问：“你能像对一个十岁小孩解释那样告诉我，为什么口腔菌群糟糕，进ICU的概率就会暴增9倍？” ```mermaid flowchart TD accTitle: 口腔疾病恶化新冠并发症的机制 accDescr: 图表展示牙周病通过细胞因子风暴和细菌超级感染两条路径导致严重肺部并发症 subgraph OralCavity["口腔病理状态"] PD["牙周病 / 口腔微生态失衡"] end subgraph Pathway1["炎症风暴级联反应"] IM["牙周组织持续释放炎性标志物"] CS["新冠诱发的全身细胞因子风暴"] Fire["双重炎症叠加<br/>'火上浇油'导致器官衰竭"] end subgraph Pathway2["继发性细菌感染"] OB["有害口腔细菌顺行下行"] Lung["免疫透支的肺部"] Pneu["细菌性超级感染<br/>致死性肺炎"] end PD --> IM IM --> Fire CS --> Fire PD --> OB OB --> Lung Lung --> Pneu ``` 桑普森医生指出，这一致命关联主要通过两条路径发挥作用： 1. **炎症与“细胞因子风暴”（Cytokine Storm）：** 新冠病毒进入人体后会诱发大规模的全身性炎症反应，即细胞因子风暴；而牙周病本质上是牙龈的慢性炎症，源源不断地向全身血液循环泵出大量的炎性标志物。当口腔炎症遇上新冠感染，两者叠加无异于“向火上浇汽油”，使得本就危险的免疫风暴彻底失控。 2. **继发性“细菌超级感染”（Bacterial Superinfection）：** 尸检病理学证据显示，新冠重症死者极少单纯死于病毒本身，最核心的死因其实是并发症，尤其是细菌感染。当患者身体遭受病毒重创、免疫系统彻底超负荷运转时，体内的有害细菌便迎来了趁虚而入的黄金窗口期。尸检明确发现，大量原发于口腔的细菌顺着呼吸道长驱直入侵染肺部，引发了难以控制的继发性细菌性肺炎，这才是夺走绝大多数患者生命的真正元凶。 ### [13:06](https://www.youtube.com/watch?v=p3fSwd1cF08&t=786s) 致命的口腔细菌与被忽视的全身关联 面对口腔微生物竟能直接致人于死地的冷酷现实，史蒂芬惊叹普通人从未设想过口腔细菌具备如此惊人的杀伤力。桑普森医生坦言，即便是专业的牙医在医学院受训期间，也普遍缺乏对口腔细菌波及全身健康深远影响的足够教育。 在传统医学教学中，唯一一个深入人心的典型范例是感染性心内膜炎（Infective Endocarditis）： - 任何做过心脏瓣膜或心血管手术的患者，术后大约 6 个月内都被严格禁止接受常规的洗牙或牙周洁治（Dental Hygiene）。 - 这是因为洁治过程中微细的牙龈创口会让口腔细菌进入血液并下行，一旦细菌附着在受损或人工的心脏瓣膜上，极易诱发致命的感染性心内膜炎。 - 然而令人遗憾的是，医学界长期以来仅仅将目光局限在心脏这一处特例上，完全忽视了口腔菌群向其他重要器官转移病变的普遍机制。 ### [13:55](https://www.youtube.com/watch?v=p3fSwd1cF08&t=835s) 加工食品如何“重塑”人类下颌与牙齿排列 在探讨更多具体病症之前，史蒂芬将话题转向了人类面部解剖的退化，回忆起作家詹姆斯·内斯特（James Nestor）曾指出现代人的下颌和口腔结构因为过度摄入软质加工食品而发生了“畸形发育”。他向桑普森医生求证这一说法的真实性。 桑普森医生给出了百分之百的肯定回答，并详细介绍了牙医界先驱威斯顿·普莱斯（Weston A. Price）的经典调查： - **跨文化与双胞胎对照研究：** 普莱斯曾敏锐地观察到，生活在西方工业化社会的人群，其龋齿发生率远高于原始部落，且普遍伴有严重的牙列拥挤和窄小的下颌。为此他走遍世界各地，深入偏远原住民部族进行田野调查，甚至对比了分开生活在工业化城市与传统村落中的同卵双胞胎。 - **饮食对骨骼发育的决定性作用：** 调查发现，生活在非工业化地区、以未经精细加工的粗硬食物为主食的孩子，颌骨在咀嚼力量的刺激下发育得宽大而匀称，牙齿极其整齐且几乎完全没有蛀牙；反观身处现代工业环境中的孩子，从小摄入大量无需费力咀嚼的精制软食和高糖食物，肌肉与颌骨缺乏足够的机械力刺激而严重发育不足。 - **“牙齿没变小，空间变小了”：** 人类的牙齿尺寸在演化历程中并未发生变化，但由于下颌骨整体退缩、空间急剧缩水，恒牙失去足够的萌出位置，最终导致现代社会普遍出现牙齿交叠和严重拥挤。 - **现代正畸热潮的根源：** 这种退化直接解释了为何如今极高比例的儿童不得不依赖正畸牙套来排齐牙齿。远古时期的穴居人既没有牙医、没有牙套，甚至连牙膏都没有，却几乎从未遭受牙列拥挤或因严重牙病死亡的困扰，现代人的口腔骨骼发育危机本质上是一场“饮食演化病”。 ### [17:03](https://www.youtube.com/watch?v=p3fSwd1cF08&t=1023s) 32岁长智齿？智齿的起源与演化谜题 聊到下颌空间不足，史蒂芬结合自身的尴尬处境提出了疑问：他今年已经 32 岁，但左右两侧的下颌骨处却正在萌出智齿，他自嘲道：“我怎么会在 32 岁时还在长牙？我都以为自己是在走下坡路、快入土了。”他好奇智齿的名字究竟从何而来，为什么人的牙齿会在这个年纪才冒出来？ 桑普森医生梳理了人类牙齿发育的时间线： - **乳牙阶段：** 通常在出生后逐渐长齐，并维持到大约 6 至 7 岁。 - **恒牙替换阶段：** 从 6-7 岁开始换牙，大部分成人恒牙在 12 岁左右完成萌出。 - **停滞休眠期：** 12 岁到大约 18、19 岁之间，口腔内基本保持静止，不再有新牙萌生。 - **智齿阶段（第三磨牙）：** 通常在 18 至 19 岁之后才姗姗来迟。正如其英文名“Wisdom Teeth”所暗指的那样，因为它们往往在一个人成年、心智成熟并拥有更多“智慧”的年龄段才长出，因而得名。 她解释道，智齿是人体内极其不可控且特立独行的一组牙齿： - 有些人在 18 岁准时萌出；有些人体内完全没有智齿牙胚；有些人智齿生长方向端正，毫无病痛。 - 但另一些人（例如史蒂芬）却会在 30 多岁时突然萌动，而且极易形成阻生智齿（Impacted Wisdom Teeth）——即智齿完全横向平躺生长，直接顶在前方正常生长的磨牙上。 - 由于过去三四十年间现代人下颌骨因饮食过度精细化而进一步变窄，阻生智齿的发生率较以往大幅攀升。这种横向生长的骨埋伏智齿不仅是患者经受剧痛与发炎的梦魇，在临床拔除操作上也是令牙科医生极其头疼的重大技术挑战。 ### [18:23](https://www.youtube.com/watch?v=p3fSwd1cF08&t=1103s) 智齿的演变与“穴居人饮食”的真相 斯蒂芬·巴特利特（Steven Bartlett）首先抛出了一个进化论问题：我们究竟为什么需要智齿？维多利亚·桑普森医生（Dr Victoria Sampson）直言，从现代解剖学来看，人类确实没有保留智齿的实际需求。甚至有前沿研究表明，越来越多的人天生就不再长智齿——随着越来越多的人在青少年或成年期拔除智齿，进化似乎在悄然发挥作用，不少人的后代已经完全缺失了智齿胚。尽管如此，桑普森医生在临床上并不主张盲目拔除健康的智齿。她的原则是“牙齿越多越好”（"the more teeth the better"），因为这些智齿未来可能在其他牙齿受损时充当备用的自体移植物或锚定支点。 随后，斯蒂芬提出了一个看似无懈可击的逻辑悖论：如果500年前的祖先没有牙医、没有牙膏、没有牙线，却几乎不长蛀牙，那为什么现代人还需要这些清洁工具？桑普森医生指出，关键在于饮食结构的剧变。如果一个人愿意完全回归“穴居人饮食”（Caveman diet）——只吃生肉、只喝纯水，彻底杜绝任何糖分和碳水化合物，那他或许真的可以一生不碰牙刷和牙线。然而现代加工食品中充斥着精制糖与高碳水化合物，直接破坏了口腔唾液的酸碱平衡。 蛀牙的病理机制本质上是一场化学反应：口腔内的细菌以饮食残渣中的糖分和碳水化合物为食；在发酵这些糖分的过程中，细菌会代谢释放出大量酸性物质；这些酸性物质若未能及时被清除，便会持续腐蚀牙釉质，引发“去矿化”（Demineralization），去矿化的最终恶果就是牙齿实质性缺损，即蛀牙。 - **智齿的进化趋势**：由于颌骨缩小和人为拔除干预，现代人群中天生缺少智齿基因表达的比例正在逐渐增加。 - **蛀牙发生链条**：糖类/碳水化合物摄入 $\rightarrow$ 细菌代谢发酵 $\rightarrow$ 释放酸性代谢物 $\rightarrow$ 牙釉质去矿化 $\rightarrow$ 形成龋洞。 --- ### [20:31](https://www.youtube.com/watch?v=p3fSwd1cF08&t=1231s) 口腔微生态的个体差异与宿主免疫反应 针对斯蒂芬关于“每个人的口腔菌群是否大相径庭”的疑问，桑普森医生给出了极其肯定的回答：“差异极其巨大。”早年她在开展口腔微生态检测时，曾遇到一个困惑的临床现象：当检测同一对伴侣时，由于常规检测仅筛查致病力最强的20余种常见细菌（无法穷尽口腔内全部700多种细菌），两人的化验单看起来几乎一模一样；然而一检查口腔，其中一人可能患有严重的牙周炎和牙龈溃烂，另一人的牙龈却完美无瑕。 这一现象让她意识到，疾病的发生不仅仅取决于“存在哪些细菌”，更取决于患者体内的具体“细菌菌株”（Strains）以及宿主自身的免疫反应机制。即使是同一种细菌，不同菌株的毒力也天差地别——有的菌株极具侵袭性与破坏力，而有的菌株却与人体和平共处。为此，她在自研的检测方案中引入了菌株分辨率分析，并综合评估有益菌与有害菌的比例、整体菌群多样性、基因突变易感性以及体内的炎症反应水平。 这种宿主反应的差异解释了一个残酷的临床事实：许多患者每天早中晚刷三次牙、使用牙线、从不吸烟且饮食极其健康，却依然遭受严重的牙周病折磨。这是因为他们携带特定的遗传基因突变，使得免疫系统对哪怕微量的口腔细菌都会产生过度、激进且破坏性的炎症反应，从而在极高卫生标准下依然发生组织破坏。 --- ### [22:58](https://www.youtube.com/watch?v=p3fSwd1cF08&t=1378s) 牙齿：人体唯一不脱落的表面 斯蒂芬联想到此前与肠道健康专家蒂姆·斯佩克特（Tim Spector）的对话，提到肠道菌群每隔几天到几周就会自动更替淘汰，便询问口腔菌群的代谢周期有何不同。桑普森医生揭示了一个根本性的生物学差异：肠道拥有持续的机械蠕动（Peristalsis），黏膜细胞与菌群随之不断剥落、更迭；但牙齿不同，**牙齿是整个人体中唯一不发生脱落的物理硬表面**（"the only non-shedding surfaces in the whole body"）。 桑普森医生做了一个生动形象的比喻：如果一个人一辈子不洗澡，由于全身皮肤表皮细胞每天都在代谢脱落，身体在微观层面依然在进行“自我清洁”；但如果你永远不刷牙，牙齿表面毫无自我剥落机制。附着在其表面的细菌只会不断积聚、增殖，形成顽固而深厚的牙菌斑生物膜。因此，仅靠人体自身的生理代谢无法清除口腔细菌，必须依靠牙刷、牙膏以及专业牙科洁治等物理机械手段进行定期清理与剥离。 --- ### [24:21](https://www.youtube.com/watch?v=p3fSwd1cF08&t=1461s) 吞咽唾液会致病吗？7岁患儿的真实困境 谈及口腔细菌对全身健康的渗透，斯蒂芬承认自己有个近乎“迷信”的强迫观念：每当感冒生病或喉咙发炎时，他都会极力避免吞咽口水，生怕口腔中的病菌顺着食道扩散到全身导致病情加重。他好奇这种担忧在科学上是否有依据。 桑普森医生对此报以理解，并分享了前一天接诊的真实案例：一名年仅7岁的小男孩不知何故突然产生了这个认知，觉得自己的唾液“太恶心了”，里面全是坏细菌，每天吞咽口水等于把病菌送入全身各处。于是小男孩彻底拒绝吞咽唾液，整天任由口水往外流，用衣袖擦拭或随身带着毛巾擦嘴，导致面部周围长满了大面积的接触性皮疹。桑普森医生感慨，虽然孩子的反应极端，但他思考的问题在病理学上并非毫无道理——人类口腔中确实容纳了超过700种、总计约20亿个细菌，吞咽唾液确实意味着大量细菌沿消化道下行。 不过，健康人体内置了极其坚固的防御屏障：强酸性的胃液会杀灭绝大部分随唾液咽下的细菌。只有毒力极强、耐酸或产生特殊适应机制的恶性致病菌，才能突破这道屏障在下消化道或全身存活并引发系统性病变，这正是维持口腔菌群平衡至关重要的原因。 --- ### [26:14](https://www.youtube.com/watch?v=p3fSwd1cF08&t=1574s) 低度慢性炎症：牙龈出血绝非“正常现象” 除了细菌的直接物理迁移，口腔健康恶化危害全身的另一条核心通路是**低度慢性炎症**（Low-grade chronic inflammation）。健康状态下，口腔内的有益菌占据主导，压制少量有害菌；一旦发生菌群失调（Dysbiosis），有害菌过度繁殖，不仅会向全身各处扩散，还会持续合成并释放大量促炎介质（Inflammatory markers）。 这些源自牙周组织的炎性因子会渗透进入血液循环，加剧全身远端器官的原有炎症。例如，类风湿性关节炎（Rheumatoid arthritis）患者如果同时患有牙龈炎，其牙周组织释放的炎症因子会顺着血流直达手腕关节，直接加重关节的肿胀与退化。 ```mermaid flowchart TD accTitle: Oral Dysbiosis Systemic Impact Pathways accDescr: 口腔菌群失调通过两条路径影响全身健康：一是细菌直接迁移，二是释放促炎介质引发低度慢性炎症。 subgraph OralMouth ["口腔环境失衡"] A["菌群失调 Dysbiosis<br/>(有害菌比例超标)"] end subgraph Pathways ["致病通路"] B["通路一: 细菌直接迁移<br/>(耐酸恶性菌穿透胃屏障)"] C["通路二: 促炎介质释放<br/>(低度慢性全身炎症)"] end subgraph SystemicImpact ["全身性健康威胁"] D["远端器官感染与消化道失衡"] E["加重全身退行性病变<br/>(如: 类风湿性关节炎恶化)"] end A --> B A --> C B --> D C --> E ``` 最危险的一点在于，低度慢性炎症往往在人体内悄无声息地进行，极易被公众忽视。桑普森医生指出，临床上有大量患者轻描淡写地表示“我的牙龈每次刷牙都会出血，但这很正常”。她尖锐地反驳道：如果一个人的眼球或脚底每天都在渗血，任何人都会惊恐万状地立刻冲进急诊室；然而当出血发生在口腔黏膜时，公众却将其误当成无害的日常琐事，任由这种持续的全身炎症温床吞噬身体机能。 ### [27:36](https://www.youtube.com/watch?v=p3fSwd1cF08&t=1656s) 牙龈出血的警讯与血管损伤机制 很多人在刷牙看到牙龈出血时往往不以为意，但 Dr. Victoria Sampson 指出，如果身体其他部位每天都在流血，任何人都会感到恐慌并意识到严重发炎的存在。牙龈出血其实是身体在发出无声的呐喊，警示局部炎症正在向全身蔓延。除了吞咽和吸入，口腔细菌破坏身体健康的第三种关键机制在于直接损伤血管。口腔中的有害致病菌会释放出强效毒性酶，这些毒素随着血液循环流经全身，直接侵害血管壁，导致血管失去正常的舒张与收缩调节能力。 ```mermaid flowchart LR accTitle: 口腔致病菌损伤全身血管机制 accDescr: 展示口腔致病菌如何释放毒性酶并破坏血管功能，进而导致心血管与勃起功能障碍 subgraph 口腔病灶 A["牙周致病菌过度繁殖"] --> B["释放毒性破坏酶"] end subgraph 循环系统 B --> C["毒素进入血液循环"] C --> D["破坏血管内皮细胞"] end subgraph 系统性后果 D --> E["血管舒缩功能受损"] E --> F["心血管疾病 / 勃起功能障碍"] end ``` - **血管内皮受损**：有害细菌分泌的毒性酶使血管无法正常扩张（vasodilation）以增加血流量，也无法有效收缩，成为诱发多种系统性疾病的核心病理基础。 - **发炎扩散信号**：刷牙吐泡沫带血并非小事，而是牙周组织发炎且屏障受损的直接证据。 --- ### [28:13](https://www.youtube.com/watch?v=p3fSwd1cF08&t=1693s) 类风湿性关节炎与牙周病的双向联系及临床奇迹 Steven 提到一项令人震惊的统计数据：类风湿性关节炎（Rheumatoid Arthritis, RA）患者患严重牙周病的几率是普通人的 8 倍。Dr. Sampson 解释，这两者之间存在极其强烈的“双向关系”（bidirectional relationship）——类风湿性关节炎恶化会导致牙周病加重，控制了关节炎，牙周健康也会随之改善；反之亦然，彻底治疗牙周病能够显著缓解关节炎病情。 这一发现正是 Dr. Sampson 走上“口腔-全身连接”（mouth-body connection）医学探索之路的转折点。她分享了一位早期患者的真实案例：该患者饱受严重类风湿性关节炎折磨，行动极度困难，先后看过四五位专科医生皆未好转。直到最后一位功能医学医生询问她“最近牙齿怎么样”，患者轻描淡写地表示过去一两年因牙齿松动拔了大约 6 颗牙，觉得“老了大概就是这样”。那位医生意识到反常，立刻将她转诊至 Dr. Sampson 的诊所进行唾液检测。检测结果显示，该患者唾液中的炎症指标爆表、胶原蛋白分解速率极高，并且充斥着大量有害菌。Dr. Sampson 为其进行了积极而彻底的牙周系统治疗，奇迹随后发生：患者不仅牙龈完全康复，其全身类风湿性关节炎也出现了戏剧性好转，最终彻底停掉了类固醇等重度药物，重新恢复了正常行走能力。这一震撼的临床反馈让 Dr. Sampson 深刻意识到，牙科绝不仅仅是修补牙齿，它所带来的全身性健康价值无比巨大。 - **8 倍风险倍率**：类风湿性关节炎患者患牙周炎的概率比无该病人群高出整整 8 倍。 - **停药复行**：通过根治重度牙周炎，彻底阻断了驱动自体免疫攻击的持续炎症源，帮助患者脱离长期依赖的类固醇药物。 --- ### [30:43](https://www.youtube.com/watch?v=p3fSwd1cF08&t=1843s) 心血管疾病、高血压与心瓣膜的“魔术贴”效应 心血管疾病是全球人类的头号杀手，Steven 询问口腔微生物与心脏病、中风之间是否有明确的数据关联。Dr. Sampson 指出，临床研究显示患有牙周病的人患高血压的风险高出 20%，而在医院收治的心脏瓣膜等心脏问题中，高达 30% 到 40% 的病例可以直接追溯到口腔细菌感染。 针对这一机制，Steven 引用了一项名为《系统性健康人群中牙周炎与血压之关联》的研究：牙周病患者发生心脏病发作的风险是常人的 2 倍，患中风的几率更是高达 3 倍。Dr. Sampson 补充道，血液检测中的 C-反应蛋白（CRP）是衡量全身炎症与心血管风险的核心指标；临床实验证实，仅仅通过进行专业的牙周清洁与抗炎治疗，患者血液中的 CRP 水平就会出现大幅下降。她生动地将受损或术后的心脏瓣膜比作“魔术贴”（Velcro）：它变得粗糙且具有粘性，就像人摔倒后带有伤口的皮肤在泥地里打滚一样，顺着血流或吞咽进入循环系统的口腔细菌极易吸附在心脏瓣膜上引发严重感染。为此，越来越多美国的心脏外科医生已开始与牙医展开深度跨学科合作。 - **高血压风险**：牙周病导致高血压发病率提升 20%。 - **心脏病与中风翻倍**：炎症性牙周疾病使心肌梗死风险增加 2 倍，中风风险增加 3 倍。 - **住院心脏病因**：医院内高达 30%–40% 的心瓣膜感染等病变可分离出口腔来源的致病菌。 - **CRP 显著降低**：定期的专业口腔卫生维护能直接降低血液中的关键炎性标志物 C-反应蛋白。 --- ### [33:48](https://www.youtube.com/watch?v=p3fSwd1cF08&t=2028s) 2.85倍风险：牙周病与男性勃起功能障碍（ED） 当话题转向男性健康时，Steven 坦言此前听到口腔与勃起功能障碍（Erectile Dysfunction, ED）相关时感到非常警惕。Dr. Sampson 给出了确凿的研究数据：患有牙周病的男性发生勃起功能障碍的风险是健康男性的 2.85 倍（相当于风险激增了将近两倍）。 面对 Steven“请向十岁小孩解释一样”的追问，Dr. Sampson 拆解了其中的病理逻辑：牙周病本质上是一个从轻度牙龈发炎到严重骨质流失的发展过程。早期表现为刷牙吐血，若放任不管，高浓度的有害菌群便会腐蚀牙龈与牙槽骨，造成不可逆的组织破坏。这些细菌释放的毒性酶进入循环系统后，会剥夺全身微血管的舒张功能，导致血液无法顺畅充盈至阴茎海绵体，最终引发勃起功能障碍。Steven 听后笑称这简直是“紧急事件”，Dr. Sampson 也幽默地回应道，临床上只要遇到抗拒刷牙的男性患者，她只需亮出“患 ED 概率高出 2.85 倍”这一张王牌，对方往往会立刻起身冲进洗手间认真刷牙。 | 牙周病变发展阶段 | 典型临床表现 | 系统性与血管潜在后果 | |:--- |:--- |:--- | | **初期：牙龈炎** | 刷牙出血、牙龈红肿 | 局部黏膜屏障破损，炎性因子开始释放入血 | | **中期：进展期牙周病** | 牙周袋加深、牙槽骨被有害菌侵蚀 | 菌群毒性酶损伤血管内皮，全身血管舒张障碍（诱发 ED、血压异常） | | **末期：重度牙周炎** | 牙齿松动脱落、化脓性感染 | 严重系统性炎症负荷、诱发重大心血管及自身免疫病变 | --- ### [35:56](https://www.youtube.com/watch?v=p3fSwd1cF08&t=2156s) 前沿研究：乳腺组织微生态与口腔具核梭杆菌 除了心血管与关节疾病，Steven 进一步将话题引向口腔微生态与癌症——尤其是女性高发恶性肿瘤乳腺癌的联系。Dr. Sampson 解释道，这是目前医学界最前沿的新兴研究领域之一。过去人们认为乳腺内部是无菌的，但最新研究证实，乳腺组织自身也拥有独特的微生态菌群（breast microbiome）。 科学家在比对健康女性与乳腺癌患者的乳腺微生态时得出了惊人发现：乳腺癌患者的肿瘤组织中，存在极高浓度的特定口腔有害菌——具核梭杆菌（*Fusobacterium nucleatum*）。这些原本寄生在口腔严重牙周病灶中的致病菌，能够穿透组织屏障并定植于远端乳腺组织，直接参与并改变肿瘤微环境，揭示了口腔健康与重大肿瘤发生之间潜藏的深层病理通道。 ### [36:54](https://www.youtube.com/watch?v=p3fSwd1cF08&t=2214s) 口腔细菌与癌症：具核梭杆菌的致命隐患 当话题转到口腔微生物群对身体其他器官的影响时，史蒂芬对“乳腺微生物群”的概念感到十分诧异。桑普森医生解释道，乳腺内部同样存在着属于自己的细菌群落，不仅普通人往往对此一无所知，医学界也是近年来才逐步揭开其面纱。研究人员在比对健康女性与乳腺癌患者的乳腺组织时发现，乳腺癌患者的乳房组织中存在异常高浓度的特定口腔细菌——具核梭杆菌（*Fusobacterium nucleatum*）。这种本应存活在口腔中的微生物不仅入侵了乳腺，在结直肠癌领域的研究中也频繁现身；近期主流媒体广泛报道的多项研究证实，超过50%的结直肠癌患者肠道肿瘤组织中检出了完全相同的口腔具核梭杆菌。更令人警惕的是，这种口腔病原菌的存在不仅会加速小鼠体内的肿瘤生长，还会显著增强癌症的侵袭性，导致肿瘤更加顽固、难以治疗。 面对史蒂芬关于口腔微生物与癌症之间是否存在直接“因果关系”的追问，桑普森医生表现得非常严谨。她指出，大多数癌症的发生和发展都是多因素综合作用的结果，目前尚不能断言其为直接因果，但具核梭杆菌等特定口腔细菌无疑是明确的高风险诱因，会显著助长恶性肿瘤的发生几率与侵袭程度。目前已有科研团队研发出一种专门针对具核梭杆菌的特异性抗生素，并正在针对携带该菌的结直肠癌患者开展临床试验，观察定点清除这种口腔细菌是否能延缓病程进展或改善患者预后。如果该试验取得积极结果，口腔致病菌加剧癌症恶化的证据链将变得无可辩驳。 - 乳腺癌患者乳腺组织与超过 50% 的结直肠癌患者肠道肿瘤中，均被检测出高浓度的口腔具核梭杆菌（*Fusobacterium nucleatum*）。 - 动物实验表明，具核梭杆菌能够直接加速小鼠体内的肿瘤生长。 - 具核梭杆菌的产生由多重因素驱动：口腔清洁不到位、个体遗传易感性、日常饮食结构、空气吸入物以及接吻等亲密唾液交换。 --- ### [39:31](https://www.youtube.com/watch?v=p3fSwd1cF08&t=2371s) 绿茶的神奇功效与演播室趣事 针对具核梭杆菌这种危险的口腔致病菌，桑普森医生分享了一个既日常又高效的天然解决方案——绿茶。日常饮用的绿茶在杀灭具核梭杆菌方面展现出极其出色的效果。绿茶具备显著的抗炎活性，能够有效缓解体内的氧化应激，其特有的抗菌成分更是这种癌细胞“同谋”细菌的天然克星。 在谈到绿茶的作用时，演播室里出现了一段轻松诙谐的插曲。史蒂芬立刻打趣说，桑普森医生在节目录制前偷偷给他“爆料”，说团队后方的杰克（Jack）刚刚做过唾液检测，体内的具核梭杆菌已经泛滥成灾、“彻底失控”。桑普森医生笑着附和，透露自己为了救急甚至送了杰克“一大桶绿茶”作为礼物。史蒂芬随即大笑调侃道：“这家伙回头剪辑视频时肯定会把这段掐掉！”桑普森医生重申，绿茶虽然容易在牙齿表面留下茶渍，但其对抗氧化应激、抗炎以及定点清除具核梭杆菌的健康收益，是维护口腔乃至全身微生态的一大天然利器。 --- ### [41:10](https://www.youtube.com/watch?v=p3fSwd1cF08&t=2470s) 咖啡、茶与糖分摄入的口腔法则 针对现代人离不开的日常饮品，史蒂芬询问了咖啡对口腔微生物的影响。桑普森医生坦言自己也是个咖啡爱好者，并澄清咖啡本身并不会直接毒害或破坏口腔菌群，其真正的隐患在于“导致口干”。唾液在口腔生态中扮演着全天候物资配送系统的角色，源源不断地向益生菌输送生存所需的蛋白质与各类营养；一旦大量饮用咖啡、处于高度紧张状态或服用抗抑郁药物，唾液分泌量骤减，这套滋养益生菌的供给链就会断裂，从而导致有益菌大量饿死，有害菌乘虚而入。 ```mermaid flowchart TD accTitle: 进食糖分模式与龋齿发生机制对比 accDescr: 对比长时间啜饮加糖热饮与单次快速吃完对唾液酸碱度平衡的不同影响 subgraph WrongWay ["高风险模式：长时间啜饮加糖饮品"] A1["每隔几分钟啜饮一口加糖热茶/咖啡"] A2["唾液酸化并试图中和"] A3["反复酸碱震荡导致中和机制瘫痪"] A4["口腔持续处于酸性环境 -> 诱发脱矿与严重龋齿"] A1 --> A2 --> A3 --> A4 end subgraph RightWay ["安全模式：集中一次性摄入"] B1["短时间内一次性喝完饮品或吃完甜食"] B2["口腔唾液一次性中和酸性"] B3["唾液 pH 迅速恢复中性健康状态"] B1 --> B2 --> B3 end ``` 谈及英国人钟爱的茶水以及普遍存在的加糖习惯时，桑普森医生发出了严肃警告：在热茶中加入大量糖分，对牙齿的破坏力甚至远甚于直接吃一块饼干。因为白糖在热饮中完全溶解，且饮用时液体温度较高，对牙釉质的渗透和侵蚀更加隐蔽而剧烈。更致命的是饮用方式——很多人喜欢把加了四五块方糖的热茶放在手边，花上一两个小时慢慢啜饮，这会让唾液在“变酸—中和—变酸”的拉锯中彻底瘫痪，口腔环境长期停留在酸性临界点以下，造成严重蛀牙。因此她提出了“糖分集中突击（Sugar Attack）”的概念：如果想吃甜食或喝甜饮，务必一次性快速解决，无论是加糖茶还是整包 M&M 豆，绝不能每隔十分钟就进食一口。至于无糖碳酸饮料，虽然没有蔗糖直接饲喂蛀牙菌，但其极低的 pH 值具有强烈的酸蚀性，会直接溶蚀牙齿外层的牙釉质，使牙齿在日后接触糖分时变得脆弱不堪。 --- ### [44:12](https://www.youtube.com/watch?v=p3fSwd1cF08&t=2652s) 牙龈疾病与阿尔茨海默病：直通大脑的隐形杀手 随着对话深入到大脑健康与认知衰退，史蒂芬表示自己随着年龄增长，对阿尔茨海默病、痴呆症以及保持敏锐认知表现格外关注。桑普森医生指出，口腔健康与大脑认知功能之间存在着令人震惊的紧密联系。一项针对超过20,000名受试者进行了长达20年追踪的大规模人群队列研究显示，患有慢性牙龈疾病超过10年的人群，其日后发展为阿尔茨海默病的风险惊人地增加了70%。 ```mermaid flowchart LR accTitle: 牙龈卟啉单胞菌侵袭大脑致病机制 accDescr: 口腔病原菌牙龈卟啉单胞菌穿透血脑屏障并释放牙龈蛋白酶破坏大脑组织的完整路径 subgraph OralCavity ["口腔病灶"] P1["慢性牙龈疾病"] P2["牙龈卟啉单胞菌 (P. gingivalis)"] P1 --> P2 end subgraph BarrierCrossing ["血行播散"] P3["血液循环 / 临近神经组织"] P4["突破血脑屏障 (BBB)"] P2 --> P3 --> P4 end subgraph BrainDamage ["脑组织退变"] P5["释放毒性牙龈蛋白酶 (Gingipains)"] P6["降解破坏神经元与脑组织"] P7["阿尔茨海默病 / 认知衰退"] P4 --> P5 --> P6 --> P7 end ``` 更深层的分子病理学研究进一步揭示了潜在的致病途径。在所有口腔微生物中，牙龈卟啉单胞菌（*Porphyromonas gingivalis*）堪称危险程度最高的一类病原菌。由于口腔与颅脑解剖结构极为相邻，这种细菌不仅能顺着血液或组织一路向上，更能直接突破人体严密防护的血脑屏障。进入大脑后，牙龈卟啉单胞菌会大量释放名为“牙龈蛋白酶（Gingipains）”的毒性蛋白水解酶。这些酶就如同失控的破坏机器，会肆意降解神经元并摧毁关键脑组织。令人震惊的病理检测表明，在阿尔茨海默病患者的脑脊液与脑组织标本中，高达97%检出了这种牙龈蛋白酶；而在非阿尔茨海默病患者的健康脑组织中，检出率完全为零（0%）。这一压倒性的病理反差表明，牙龈致病菌及其分泌的毒性酶不仅仅是简单的相关因素，更是推动阿尔茨海默病发病机制的强大潜在促成因子。桑普森医生随后引申到关于已经确诊认知衰退的患者、继续维护口腔清洁是否仍有意义的前沿干预研究。 ### [46:40](https://www.youtube.com/watch?v=p3fSwd1cF08&t=2800s) 阿尔茨海默病与牙周致病菌的因果链条 在一项针对阿尔茨海默病患者的研究中，研究人员评估了患者的认知功能与口腔健康状况，并在六个月后进行了随访复查。结果显示，患有牙周病的患者其认知功能衰退速度远快于没有牙周病的患者。Victoria 医生指出，即使已经确诊阿尔茨海默病，维持口腔卫生依然生死攸关，患者需要专人协助刷牙，否则认知能力的恶化速度会被急剧放大。对此，Steven 提出了关键质疑：如何将牙周病本身的影响与其他生活方式因素剥离？日常饮用含糖碳酸饮料的人不仅更易患牙周病，其摄入的化学物质、缺乏运动的不良生活方式，都可能独立推高失智风险。 Victoria 坦言，要彻底解开这种多因素交织的网络极其困难，流行病学上往往需要依赖海量样本量来确认二者的强相关性。但更为直接的生物学证据来自对牙龈卟啉单胞菌（*Porphyromonas gingivalis*）及其分泌的牙龈蛋白酶（Gingipains）的研究。这项机制研究表明，这不仅仅是饮食或生活方式的问题，而是具体的口腔致病菌穿透屏障侵入大脑，释放出能够直接分解、破坏神经元的酶蛋白。 针对阿尔茨海默病的预防，Victoria 的团队将各种已知风险因素进行了归类拆解。例如携带 *APOE* ε4 等基因突变的人群具有更高的患病风险，但基因是无法改变的宿命；相比之下，牙龈卟啉单胞菌和牙龈蛋白酶却是完全可控的风险因子。Victoria 创办的机构提供了专门针对牙龈蛋白酶的唾液检测，在市场上独树一帜，因为单纯检测细菌存在并不足够，更重要的是确认该细菌是否正在口腔内高度活跃并产生毒性破坏。Steven 随即笑着透露，包括他自己在内的多位团队成员其实都刚刚接受了这项唾液检测，当天就会揭晓检测报告。 ```mermaid flowchart TD accTitle: 口腔细菌与阿尔茨海默病关联机制 accDescr: 展示牙龈卟啉单胞菌产生牙龈蛋白酶并跨越血脑屏障破坏神经元的病理过程 subgraph OralMouth ["口腔环境"] A["牙周炎 / 牙周病"] --> B["牙龈卟啉单胞菌<br/>(P. gingivalis) 滋生"] B --> C["分泌毒性酶类<br/>(Gingipains / 牙龈蛋白酶)"] end subgraph SystemicSpread ["体内扩散与侵入"] C --> D["穿透口腔黏膜与血液循环"] D --> E["跨越血脑屏障进入脑组织"] end subgraph BrainImpact ["大脑神经退行性病变"] E --> F["牙龈蛋白酶破坏分解神经元"] F --> G["加速认知功能衰退<br/>(阿尔茨海默病恶化)"] end ``` - **研究发现**：伴有牙龈疾病的阿尔茨海默病患者，在短短六个月内的认知衰退速度显著快于口腔健康的对照组。 - **不可变 vs 可变风险**：*APOE* ε4 基因变异属于无法更改的遗传风险，而牙龈卟啉单胞菌及其释放的牙龈蛋白酶则属于可通过干预清除的可变风险。 --- ### [49:44](https://www.youtube.com/watch?v=p3fSwd1cF08&t=2984s) 心理健康与进食障碍在口腔中的显现 在探讨大脑与口腔的关系时，Steven 询问抑郁、焦虑等心理健康状况是否会与口腔微生物组产生联动。Victoria 解释称，两者之间存在强烈的相关性，但究竟是“先有鸡还是先有蛋”尚无定论。当个体的心理健康恶化时，往往会首先丧失自我照料的动力，停止规律刷牙与清洁，从而引发或加剧牙龈疾病；尽管有部分关于精神分裂症与口腔菌群关联的研究，但确切的因果关系在学界仍未达成共识。 尽管微生物组的因果因人而异，但牙医往往能一眼看穿患者心理层面的异常震荡。Victoria 分享了一个临床案例：一位她接诊了五六年的女患者平日极度自律、牙齿打理得无可挑剔，但数周前复诊时，整个口腔却呈现出一片狼藉的崩溃状态。Victoria 当即把她拉到一旁关切地询问：“你身上究竟发生了什么？”正如临床所见，个人生活遭遇重大挫折或极度焦虑时，口腔卫生往往是第一个被彻底放弃的防线。 除心理崩溃引发的卫生废弛外，神经性贪食症（Bulimia）或厌食症（Anorexia）等进食障碍在口腔中也有着无法掩饰的物理痕迹。由于催吐会导致强酸性的胃酸频繁反流倒灌进入口腔，患者的牙齿会出现大面积的特征性酸蚀脱矿。此外，为了催吐，手指或工具频繁抠弄咽喉还会在上颚黏膜留下明显的擦伤与压痕。这类迹象常出现在年轻青少年身上，一旦发现，医生必须私下与患者沟通或通知其家属介入干预。 - **行为退化表征**：极度抑郁或生活变故时，自暴自弃的患者往往不仅增加吸烟、饮酒与糖分摄入，更会直接停止日常刷牙。 - **催吐典型体征**：胃酸反复腐蚀造成的牙齿硬组织大面积酸蚀，以及机械性催吐在上颚形成的物理划痕与黏膜创伤。 --- ### [52:18](https://www.youtube.com/watch?v=p3fSwd1cF08&t=3138s) 压力、皮质醇与胶原蛋白崩解机制 即便剥离掉高糖饮食、烟酒等外在生活方式行为，单纯的慢性压力与皮质醇激增本身也会对口腔健康造成直接打击。Victoria 指出，持续的压力会使全身炎症标志物飙升，同时引发唾液分泌减少、口腔干燥，形成破坏口腔微环境的双重夹击。为了在分子层面量化这种损伤，Victoria 的诊所常规检测一种名为活化基质金属蛋白酶-8（aMMP-8）的生物标志物。由于牙龈组织由特定的胶原蛋白纤维构成，而 aMMP-8 正是负责分解该胶原蛋白的关键酶，因此它是预测牙周不可逆骨质破坏与软组织塌陷的前瞻性指标。 谈及压力对该指标的极端影响，Victoria 讲述了一起令人心碎的真实病例。一位身体一贯极其健康的女性患者前来检测 aMMP-8 时，读数竟然爆表，创下了诊所历史最高纪录；然而令人困惑的是，当时女子的牙龈肉眼看起来依然平整完好，没有明显的红肿溃烂。Victoria 追问原因才得知，这位患者在仅仅几天前不幸失去了自己的婴儿。这种毁灭性的剧烈心理创伤激发出身体极端的应激反应，在宏观病变显现前，已经在分子层面引爆了剧烈的胶原蛋白崩解。六个月后复查时，患者的情绪逐渐平复，指标才奇迹般恢复至正常水平。 - **生理反应机制**：高企的压力与皮质醇会同步推高全身炎症因子，诱发口干症，使牙龈组织对致病菌的防御力骤降。 - **生物标志物监测**：通过检测 aMMP-8 酶的活性，可以在肉眼可见的牙周组织破坏发生之前，提前洞察深层的胶原蛋白流失与隐形牙周炎风险。 --- ### [53:54](https://www.youtube.com/watch?v=p3fSwd1cF08&t=3234s) 口呼吸的全身危害：从面部发育到儿童多动症 Steven 援引畅销书《呼吸》（*Breath*）作者 James Nestor 的观点，探讨了人类因食物变软导致颌骨变小、进而引发口呼吸与鼻呼吸的争议，并询问口呼吸与注意缺陷多动障碍（ADHD）之间是否存在内在关联。Victoria 对此完全认同，并分享了自己家庭诊所的行医经验。Victoria 的亲妹妹是一名正畸专科医生，她们与母亲共同经营诊所，其妹妹的工作核心之一就是纠正儿童的张口呼吸问题。 临床观察表明，长期习惯张口呼吸的儿童往往伴随着惊人一致的病理特征集合：他们极大概率患有 ADHD 或注意力缺陷障碍，并高频出现夜间遗尿（尿床）、夜磨牙等一系列连锁神经系统与睡眠障碍问题。Victoria 解释说，儿童时期的颌面骨骼尚未完全骨化定型，具有极高的可塑性，通过正畸早期干预恢复上下牙弓的正确咬合与上下唇自然闭合，孩子便会自然切换回鼻腔呼吸模式，上述并发症状往往能迎刃而解。 然而，一旦进入成年期，这种代偿性病变将变得极难逆转。大量成人口呼吸患者的根源在于上下颌骨位置异常或严重咬合错位，导致面部肌肉在静止状态下双唇无法自然闭拢，只能被迫依靠口腔呼吸。在骨骼完全定型的成年阶段，想要重新移动颌骨、重建牙齿咬合以恢复鼻呼吸，难度与代价都将大幅提升。 - **儿童口呼吸伴发症候群**： - 注意力缺陷多动障碍（ADHD）或不同程度的专注力涣散 - 睡眠呼吸紊乱导致深睡眠受阻，频繁诱发夜间遗尿（尿床） - 伴发严重的夜间磨牙与咬合肌群紧张 - **干预窗口期差异**：儿童颌骨质地柔软、未完全骨化，早期正畸调整牙弓与咬合即可轻松重塑呼吸习惯；成人颌骨已完全成型，结构性错颌导致的被动口呼吸矫正难度极高。 ### [55:59](https://www.youtube.com/watch?v=p3fSwd1cF08&t=3359s) 口呼吸 vs. 鼻呼吸：被忽视的气道过滤器与健康隐患 维多利亚·桑普森（Dr Victoria Sampson）指出，许多前来进行口腔咨询的患者往往伴随着其他复杂的全身性健康困扰，例如长新冠（long COVID）后遗症、慢性疲劳综合征以及全身性的慢性炎症。医学界已经逐渐发现，习惯性口呼吸与这些慢性健康问题之间存在着深刻的病理联系。斯蒂芬·巴特利特（Steven Bartlett）补充提到，鼻腔在生理结构上相当于人体精密的气体过滤系统，内部不仅拥有恒定的温湿度调节能力，还分布着布满黏液的鼻窦和纤毛组织，能够高效截留空气中的细菌与颗粒物；相比之下，如果直接用嘴呼吸，口腔微生物组是否会随之恶化？ 桑普森医生给出了百分之百肯定的回答。口呼吸完全绕过了鼻腔这一天然防线，空气未经任何过滤直接被吸入肺部，致病菌和杂质长驱直入。针对这种现象，如今在健康圈兴起了一种“口部贴胶带（mouth taping）”的流行趋势。尽管在夜间睡觉时把嘴贴上听上去有些怪异且不易坚持，但桑普森医生认为这是一种极佳的自我筛查方式。通过口部贴胶带入眠，配合智能手表等穿戴设备监测身体数据，很多人会惊讶地发现自己的夜间血氧水平大幅改善、深睡眠时间明显延长。若证实口呼吸确实在拖累睡眠质量，患者就会有更强烈的动力去通过牙齿正畸或耳鼻喉治疗，彻底根除用嘴呼吸的生理诱因。 - **儿童睡眠呼吸障碍与多动症风险**：斯蒂芬援引了一项针对 11,000 名儿童、为期长达 6 年的大型追踪研究，结果令人震惊：患有睡眠呼吸障碍（如夜间口呼吸、打鼾）的儿童，出现类似注意缺陷多动障碍（ADHD-like symptoms）的几率比正常鼻呼吸儿童高出整整 50% 至 90%。 - **大脑供氧机制**：口呼吸无法将富含氧气且经过净化调温的高质量气流输送给机体，导致夜间大脑长期处于轻度缺氧状态，从而直接破坏神经认知发育与日常脑功能运转。 ```mermaid flowchart TD accTitle: 呼吸方式对全身与大脑健康的路径影响对比 accDescr: 对比鼻呼吸与口呼吸在过滤、含氧量和健康后果上的差异 subgraph NosePath["鼻呼吸通道（正常生理）"] A["鼻腔黏膜与鼻窦"] -->|"加温/加湿/过滤杂质与细菌"| B["优质清洁气流"] B -->|"充分供氧"| C["大脑发育与深度修复睡眠"] end subgraph MouthPath["口呼吸通道（病理状态）"] D["直接经口吸气"] -->|"无过滤系统，直达肺部"| E["细菌杂质侵入 / 浅呼吸"] E -->|"夜间供氧不足"| F["全身炎症 / 慢性疲劳 / ADHD样症状风险增加 50%-90%"] end ``` --- ### [58:22](https://www.youtube.com/watch?v=p3fSwd1cF08&t=3502s) 接吻与微生物交换：亲密接触如何重塑口腔生态 当斯蒂芬半开玩笑地询问自己是否还能继续亲吻伴侣时，桑普森医生给予了积极鼓励，但也解释了接吻背后的微生物学机制。如果两个人每天接吻达到或超过一定频率（例如每天深吻十几次），双方的口腔微生物组会在相当程度上发生同步与趋同。在一项对照实验中，研究人员让伴侣中的一方咀嚼大量特定的益生菌补充剂，随后与另一方进行长时间的热吻，检测发现高达 60% 至 70% 的有益菌群直接转移到了对方的口腔中。 不过，桑普森医生也打消了公众的过度焦虑：在夜店或社交场合与某人偶然接吻一次，并不会永久性地毁掉一个人的口腔菌群；菌群的同化主要发生在长期伴侣之间。长相厮守的情侣之所以拥有高度相似的口腔菌群，除了频繁接吻带来的细菌交换外，往往还因为共享了完全一致的生活方式——他们通常进食相同的饮食、生活在同一微环境中，甚至在浴室里共用同一款牙膏。 - **接吻与菌群趋同**：高频、长时间的接吻会导致伴侣间细菌群落快速交融，短期实验证明单次深吻即可转移伴侣口中多达 60%~70% 的新摄入细菌。 - **偶然接触与长期影响**：偶尔一次的浅吻不足以造成永久改变，健康的口腔微生物组具备一定自我恢复韧性，但长期亲密共处则必然形成菌群共享生态。 --- ### [59:32](https://www.youtube.com/watch?v=p3fSwd1cF08&t=3572s) 口交风险与牙龈炎症：隐秘病灶的交叉感染与个人轶事 两性生活中的口交行为同样会直接改变口腔微生态。桑普森医生分享了一个临床真实病例：一位女性患者因牙龈严重红肿发炎（牙龈炎）反复前来就诊，经过标准治疗后仍旧不见好转，牙龈持续渗血并处于高度充血状态。在排除了常规口腔诱因后，女患者私下向医生倾诉，自己最近结识了新伴侣并在亲密生活中频繁为对方进行口交，怀疑发炎是否与此有关。桑普森医生建议她让男方去泌尿科做排查，结果证实该男子长期患有反复发作的无症状或轻微尿路感染（UTI）。正是这种隐匿的生殖泌尿系统细菌通过口交逆行转移至女方的口腔黏膜，引发了顽固的牙龈免疫炎症反应。 谈及此处，现场充满了幽默的互动。桑普森医生坦言，自己曾要求一名前男友在交往前必须进行口腔微生物唾液检测，以确保其菌群健康平衡。斯蒂芬惊讶地追问她现在是否也对现任男友做了同样的要求。桑普森笑称自己一直试图说服现任进行检测，甚至告诉他“用假名登记送检都可以，我绝不偷看报告”，但现任男友坚决拒绝，抗议道：“万一测出来我的口腔菌群糟透了，你岂不是要跟我分手？”斯蒂芬打趣支持男方的决定，称做这项检测“毫无收益可言”。桑普森医生随即幽默地透露，虽然男友不肯测菌群，但她早已悄悄潜入他的卫生间，把他所有的牙刷、牙膏等口腔护理产品全部掉包换成了自己定制的专业配方，甚至把男友当作各类前沿护齿新品的人体测试员。 - **口交交叉感染机制**：生殖泌尿道病原体（如大肠埃希菌或引起尿路感染的细菌）可转移至口腔黏膜与龈沟，诱发非典型性严重牙龈炎与软组织肿胀。 - **菌群的可塑性**：桑普森医生强调，即使口腔微生物组失衡，它依然是人体中最容易通过饮食、物理清洁与靶向益生制剂进行修复调节的生态系统之一。 --- ### [01:02:37](https://www.youtube.com/watch?v=p3fSwd1cF08&t=3757s) 口腔健康与生育能力：被忽视的受孕隐形杀手 口腔内的慢性感染对男女双方的生育能力均构成显著的负面冲击。桑普森医生详细剖析了一项针对男性生育力低下（subfertile men）人群的临床试验：研究人员对这批长期无法让伴侣自然受孕的男性进行了全面的口腔排查，惊讶地发现超过 90% 的男性口腔内部存在活跃的牙源性感染或牙周疾病。研究人员将这些男性随机分为两组，其中一组接受了针对性的口腔治疗——包括彻底的牙周洁治、坏死感染牙齿的拔除或根管治疗以清除所有潜在感染源；另一组则暂不处理、维持现状。 治疗随访的结果极其惊人：在清除口腔感染仅 6 个月后，治疗组男性的精子质量与精子活力平均提升了 20%；到了第 8 个月，该组男性的受孕成功率较对照组实现了高达 70% 的飞跃式改善，其中整整 50% 男性的妻子成功自然怀孕。桑普森医生强调，除了广为人知的牙周炎，牙髓坏死、未治疗的龋齿和慢性牙根尖周炎等暗藏的微小病灶，都会源源不断地向血液循环释放炎性因子，从而打击睾丸生精微环境与精子机能。 女性的受孕几率同样深受口腔健康牵制。多项医学研究表明，患有未经控制的牙龈疾病或牙周炎的女性，其正常排卵功能更容易受到系统性炎症干扰。统计数据显示，患有牙龈疾病的女性在备孕过程中，达成自然受孕所需的平均时间比口腔健康的女性整整多出两个月。更严峻的是，哪怕成功怀上胚胎，牙周病原体对整个孕期的威胁才刚刚开始。 - **男性生育力改善数据**： - 超过 **90%** 的不育/低生育力男性存在口腔感染或未经治疗的牙病。 - 清除口腔病灶 **6 个月后**：精子活力与质量提升 **20%**。 - 清除口腔病灶 **8 个月后**：受孕成功率改善 **70%**，多达 **50%** 的伴侣顺利怀孕。 - **女性受孕延迟**：患有慢性牙周与牙龈炎的女性，自然排卵和受孕难度增加，平均需要多耗费 **2 个月** 的备孕时间方能受孕。 ### [01:04:40](https://www.youtube.com/watch?v=p3fSwd1cF08&t=3880s) 孕期口腔健康、早产风险与马拉维口香糖实验 在探讨口腔微生物对孕妇健康的影响时，Victoria Sampson 医生指出，孕期女性普遍会经历“妊娠期龈炎”（pregnancy gingivitis）。由于体内荷尔蒙水平的急剧变化，牙龈极易出现严重充血、红肿和发炎，因此孕妇理应定期去看牙科洁牙师。更为关键的是，医学研究表明，患有牙周病的孕妇发生早产（preterm birth）、生下低出生体重儿（low birth weight）以及罹患子痫前期（preeclampsia）的风险要高得多。 ```mermaid flowchart TD accTitle: 孕期口腔细菌与早产风险关联机制 accDescr: 展现口腔致病菌通过血液迁移至胎盘导致早产，以及木糖醇口香糖干预的保护机制。 subgraph OralCavity["口腔微环境"] A["荷尔蒙激增 / 妊娠期龈炎"] --> B["口腔致病菌大量滋生"] C["无糖木糖醇口香糖"] -->|刺激分泌| D["唾液流量增加（缓冲滋养）"] C -->|天然抗菌| E["抑制并杀死口腔致病菌"] end subgraph SystemicSpread["系统性扩散与胎盘"] B -->|经由血液下行| F["渗透侵入胎盘组织"] F --> G["局部炎症与并发症"] end subgraph Outcomes["妊娠结局"] G --> H["早产 / 低体重儿 / 子痫前期"] E -.->|显著阻断风险| H end ``` 早产给公共医疗体系和家庭带来了沉重负担。不仅母婴需要长时间留院观察，护理成本极高，早产儿后续也往往伴随一系列健康问题。为了应对这一难题，口香糖企业箭牌（Wrigley）资助了一项在马拉维开展的大型临床研究。马拉维是全球早产率最高的国家之一，比例接近 20%。研究团队将招募的 10,000 名孕妇随机分为两组： - 干预组（5,000人）：发放无糖口香糖、牙刷和牙膏； - 对照组（5,000人）：维持常规生活，不进行额外干预。 研究结果令人震惊：仅仅通过咀嚼无糖口香糖，干预组孕妇的早产发生率就降低了整整 20%。Sampson 医生解释了背后的生理机制：首先，咀嚼无糖口香糖能够刺激唾液大量分泌，为有益菌提供生存环境；其次，配方中通常含有的木糖醇（Xylitol）具备天然抗菌活性，可有效杀灭口腔中的致病微生物。这阻止了特定口腔致病菌下行迁移至胎盘组织诱发炎症，从而以极低廉、易行的手段挽救了众多胎儿的生命。听到这里，Steven 打趣说自己也要去拿块口香糖来嚼，并顺势带出了两人此前完成的唾液检测。 ### [01:07:00](https://www.youtube.com/watch?v=p3fSwd1cF08&t=4020s) 个人精准健康赞助插播：ZOE 营养追踪 Steven 借由对自身健康的重视，谈及了本期节目的赞助品牌 ZOE。Steven 表示，自己不仅是 ZOE 的长期用户和代言人，同时也是该公司的投资人。他强调，每一次进食都是改善身体健康的机会，ZOE 结合了用户的个体生物健康数据与其世界顶级的科研成果，基于发表在顶尖期刊上的 Method Study 临床金标准试验，为用户定制最佳的饮食决策。自一年多前加入 ZOE 以来，他能够每周持续追踪身体的代谢进展，从而获得更充沛的精力、更高质量的睡眠以及更平稳的情绪。 - 优惠信息：结账时输入专属优惠码 "Steven10" 即可享受 10% 折扣。 ### [01:08:00](https://www.youtube.com/watch?v=p3fSwd1cF08&t=4080s) Steven 唾液检测报告揭晓：菌群多样性与疾病风险预测 随后，Steven 从桌下拿出了此前测试的报告文件，并将其递给 Sampson 医生进行现场解读。Steven 回忆道，前不久在公司办公室中间，有人拿着采样套件走到他面前说：“Steve，你能往这里吐口口水吗？”他答应后交出样本，后来才知道这是 Sampson 医生在节目录制前特意安排的检查。Sampson 医生介绍，该采样过程仅需大约 2 分钟，采集唾液后寄回实验室，约 3 至 4 周即可获得完整详尽的检测报告。 Sampson 医生翻开报告，首先分析了宏观层面的微生态结构： - **菌群多样性（Microbiome Diversity）**：Steven 的口腔菌群多样性极高，有益菌与有害菌之间保持着良好的平衡比例。在与健康人群及患病人群的大数据库比对中，Steven 的表现处于正态分布曲线（bell curve）的最顶端。 - **系统算法风险预测**：实验室基于特定菌种构建的预测模型显示： - 口臭风险（Bad Breath Risk）：**低**； - 牙龈疾病风险（Gum Disease Risk）：**中等**（提示局部可能存在微度炎症）； - 蛀牙风险（Decay Risk）：**中等**； - 全身性炎症风险（General Systemic Inflammation Risk）：**极低**。 Sampson 医生特别指出，许多市面检测往往只盯着有害菌，而她们的测试非常独特地纳入了经证实对口腔生态最有益的细菌种类。检测显示 Steven 体内的有益菌丰度处于高到极高的水平。在筛查的约 500 种微生物以及重点关注的 20 种高危致病菌中，绝大多数在 Steven 口中都保持在理想的安全范围内。此前节目讨论过的与勃起功能障碍相关的菌群、具核梭杆菌（*Fusobacterium nucleatum*）均表现极佳；就连与阿尔茨海默病紧密相关的牙龈卟啉单胞菌（*Porphyromonas gingivalis*），其携带的核心致病毒力因子在 Steven 的唾液样本中也完全为零。 不过，20 种高危有害菌中，Steven 仅有一种细菌的丰度偏高。Sampson 医生直言，这种细菌与牙菌斑的大量堆积强相关。尽管自己还没亲眼检查过 Steven 的口腔，但依据化验结果可以推断：Steven 最近很可能拖延了常规洁牙，“牙菌斑堆积有点超标，洗牙已经严重逾期了”。 ### [01:11:29](https://www.youtube.com/watch?v=p3fSwd1cF08&t=4289s) 基因突变报告：甜食渴求、味觉钝化与牙周炎症倾向 在微生物组测序之外，该检测还涵盖了对 10 种增加牙齿病变风险的特定基因突变的筛查。分析结果直接击中了 Steven 的个人生活习惯，引发了现场一阵欢笑与尴尬对答： | 检测维度 | 基因检测结果与生理机制 | 临床表现与生活方式映射 | |:--- |:--- |:--- | | **蛀牙易感基因** | 筛查的 5 项基因突变中，Steven 携带了 **4 项**。该突变组合会导致唾液偏向酸性，并在神经层面放大对高糖食物的偏好。 | 在面临巨大压力或情绪低落时，不同人有不同的发泄方式（如去赌场或借酒消愁），而 Steven 则会本能地投向巧克力的怀抱寻求糖分慰藉。Steven 现场连连回应“无可奉告（No comment）”、“这不关你的事”。 | | **味觉感知基因** | 携带降低味觉感知敏感度（lower taste perception）的突变基因。 | 神经系统对甜味的反馈阈值较高，普通人吃一块巧克力获得的满足感，Steven 往往需要吃掉“整整两块”才能达到。Steven 听后笑称：“录制到底结束没有？赶紧把文件合上，你怎么敢当面揭穿我！” | | **牙龈疾病易感基因** | 筛查的牙周突变中仅携带 **1 项**，且属于各类严重突变中最轻微的一种。 | 该突变不会诱发剧烈的过度免疫炎症反应（部分严重突变患者哪怕只有微量细菌，免疫系统也会失控攻击牙周组织导致严重牙周炎），但会使牙龈边缘在先天生理结构上更容易吸附、滞留菌斑，解释了为何他总是比常人更快产生牙结石堆积，需要更频繁地进行专业洁治。 | Sampson 医生总结道，虽然基因层面存在天生的吸附倾向，但由于没有恶性的超强炎症反应突变，结合检测报告提供的个性化针对性建议，只要维持稳定的专业洁牙频率并控制糖分摄入，便能阻断潜在的病变链路。 ### [01:13:49](https://www.youtube.com/watch?v=p3fSwd1cF08&t=4429s) 唾液检测的奥秘与“接吻爱犬”导致的口臭奇案 通过简单的唾液检测，实验室不仅能分析出基因变异以及问卷中的生活习惯，还能精准推导出受试者需要何种牙刷、牙膏、牙线乃至定制营养补剂与无糖口香糖。Steven 对此惊叹不已，仅仅往试管里吐一次口水，竟然能挖掘出如此海量的信息。Victoria 解释道，检测报告除了涵盖破坏性最大的前 20 种核心病原菌外，还会列出所有检测到的微生物。在临床中，有时能发现极其罕见的菌群异常升高。 Victoria 分享了一个极具戏剧性的病例：一位女患者常年饱受严重口臭困扰，但临床检查显示她的牙齿和牙龈均无明显病变。唾液检测结果却令人震惊——她口腔内高达 40% 的微生物竟然全被同一种细菌占据。Victoria 查阅资料后发现这是一种在犬类口腔中极常见的细菌。她随即询问患者家中是否有宠物狗，对方答道：“家里养了四五只狗。”当问及是否会亲吻爱犬时，患者直言不讳：“当然会，它们都是我的心肝宝贝。”原来，正是日常亲昵的吻将狗狗口腔中的菌群大批移植到了她的嘴里。 更为绝妙的是 Victoria 给出的治疗方案：她不仅指导患者清洁口腔，更给患者的所有爱犬开具了专门抑制犬类牙菌斑积聚的膳食营养补充剂。Victoria 告诉她：“根本原因是你的狗狗们患有牙周病，要想彻底治愈你的口臭，必须先治好它们。”在人与宠物全家接受系统调理后，患者多年挥之不去的口臭与狗狗的牙病一同消失得无影无踪。Steven 听罢笑着追问：“这么说养狗的人更容易口臭？”Victoria 幽默地回答，只有在爱犬患有牙周病且主人频繁和它们“深情接吻”时，才会面临这种窘境。 - **犬源性菌群感染**：个案中患者口腔微生物群有 40% 为犬类口腔特有细菌，通过亲吻传播并诱发顽固口臭。 - **人畜共患牙周问题**：治疗口臭不能仅局限于人类宿主，宠物口腔的牙菌斑和牙周病若不解决，反复接触仍会造成微生物交叉感染。 --- ### [01:16:00](https://www.youtube.com/watch?v=p3fSwd1cF08&t=4560s) 重塑口腔微生态的日常法则与进食避坑指南 对于未能进行深度唾液检测的普通大众，Victoria 强调维护微生态平衡并不需要昂贵复杂的花费，关键在于回归本质与细节管理。首当其冲的是饮食控制，尤其是减少所谓的“糖分攻击”（Sugar attack）。频繁摄入糖分会持续扰乱唾液的酸碱平衡（pH 值），因此她建议将一天的甜食摄入集中在单次解决，切忌全天断断续续地摄入糖分。日常工具也只需挑选得当的“老三样”：适合自己的牙刷、牙膏与牙线。 在刷牙的时机上，Victoria 纠正了一个极为普遍但危害巨大的误区：许多人在吃完酸性或含糖食物后会立刻跑去刷牙，试图“清除残留”，但这恰恰是在亲手磨蚀牙釉质。当酸糖在口中浸泡牙齿时，牙釉质表面处于软化脆弱状态，立刻刷牙等同于把酸和糖狠狠磨进牙体组织里，加剧脱矿。正确的做法是至少等待 30 分钟再刷牙；若想迅速缓解不适，应选择咀嚼无糖口香糖或含服木糖醇含片，通过刺激唾液分泌快速中和酸性环境。 而在刷牙结束后的动作上，Victoria 斩钉截铁地要求：**“吐掉，绝对不要用水漱口”**（Spit, don't rinse）。她再次打了个生动形象的“防晒霜比喻”：这就好比你花了整整两分钟在全身细致地涂满昂贵优质的防晒霜，结果刚迈出门去晒太阳前，却先跳进淋浴间把它冲洗得干干净净。牙膏中的有效防护成分（如氟化物或生物活性微粒）需要在牙齿和牙龈表面形成保护膜，一旦用清水彻底漱口，这些精心涂抹的益处便荡然无存。 ```mermaid flowchart TD accTitle: 进食酸糖后的科学口腔护理流程 accDescr: 展示摄入酸糖食物后避免立即磨损牙釉质的正确操作步骤及刷牙后吐掉不漱口的原则 subgraph Step1["进食酸糖后 (0-30分钟)"] A["摄入酸性/含糖食物"] --> B["口腔pH骤降 / 牙釉质软化"] B -- "严禁立即刷牙" --> C["磨蚀牙釉质 / 导致脱矿"] B -- "科学应对" --> D["咀嚼无糖口香糖或薄荷含片"] D --> E["促进唾液分泌，快速中和酸性"] end subgraph Step2["安全刷牙与后续 (30分钟后)"] E --> F["等待 30 分钟牙釉质重矿化"] F --> G["使用含氟/修护牙膏刷牙 2 分钟"] G --> H["吐出多余泡沫 (Spit)"] H -- "严禁用清水漱口" --> I["保护成分留存牙面形成屏障"] end ``` --- ### [01:18:15](https://www.youtube.com/watch?v=p3fSwd1cF08&t=4695s) 电动牙刷的优势与被 90% 人忽视的刷牙盲区 谈及手动牙刷与电动牙刷的选择，Victoria 明确倾向于电动牙刷。她指出，极少有人真正懂得如何正确刷牙，大多数人只是依照并不专业的父母辈传授的模糊习惯刷牙。更为普遍的现状是时间严重不足：医学推荐每次刷牙至少达到 2 分钟，但大众的实际平均刷牙时长仅有可怜的 20 至 30 秒，却普遍自欺欺人地认为自己刷够了时间。电动牙刷不仅内置精准计时功能，其压力传感器更能有效防止因用力过猛导致的牙龈萎缩（Gum recession）。 现场 Victoria 拿起牙齿教学模型，向 Steven 详细演示了临床上最容易被彻底遗忘的“卫生死角”——**下颌最内侧磨牙的舌侧面**（紧挨舌头的牙齿内侧）。绝大多数人刷这个部位时动作扁平敷衍，但正确的姿势是**抬高肘部**，让刷头以近乎 90 度的垂直角度探入内侧进行彻底清洁。 针对牙齿外表面，Victoria 传授了标准的巴氏刷牙法要领：刷毛不应垂直硬怼，而应与牙齿长轴呈 **30 至 45 度角朝向牙龈边缘**，采用温和打圈的旋转动作。这种微小的震颤打圈不仅能像按摩一样促进牙龈健康，更能有效拂去牙龈沟（Gum margin）内潜藏的菌斑。她告诫大家必须建立严谨的刷牙动线规划：切忌东刷一下西刷一下，应固定从某一侧外侧面开始，依次刷净全口外侧面、咬合面，再集中刷所有内侧面，随后以相同逻辑完成上颌牙列的清洁。 - **刷牙时间错觉**：大众自以为刷够了标准时间，实际平均仅有 20 到 30 秒，电动牙刷的内置计时器是弥补这一缺陷的关键工具。 - **压力保护机制**：电动牙刷的压力感应器能防止暴力横刷造成的机械性牙龈退缩及楔状缺损。 - **死角清洁手法**：清洁下后牙内侧必须“抬起手肘”将刷头垂直插入；清洁外侧面须保持 30° 斜向牙龈微弧打圈，切忌横向拉锯。 --- ### [01:20:29](https://www.youtube.com/watch?v=p3fSwd1cF08&t=4829s) 透明病理模型揭秘牙痛真相，兼论美白牙膏的磨蚀陷阱 随后，Steven 指着桌上的透明下颌模型发问。Victoria 借此向他揭示了隐藏在牙槽骨之下的微观解剖结构：模型一侧展示了种植牙（Dental implant）植入骨组织深处的形态与天然牙庞大深邃的牙根系统；另一侧则展示了一颗发黑的坏死牙齿，其牙根尖端赫然包裹着一个触目惊心的暗红色球状病灶。Victoria 指出，这就是经历了根管治疗后继发根尖周感染形成的牙槽脓肿（Abscess）。普通人平时只能感知到剧烈的“牙痛”，却从未亲眼目睹这种在骨骼深处无声破坏骨质的炎症全貌。 在聊到外貌焦虑时，Steven 调侃起英语语法（“teeth 的复数是不是 teeths”），进而切入现代人对牙齿美白（Teeth whitening）的狂热追求，坦言自己十分担忧过度追求牙齿变白会带来健康隐患。Victoria 肯定了他的疑虑，并明确将牙齿着色划分为外源性与内源性两类。 面对由日常饮用咖啡、浓茶或长期吸烟导致的外源性色素沉积（Extrinsic staining），其实根本无需使用激进化学手段，定期到诊所寻找洁牙师（Dental hygienist）做常规物理洁治与抛光就能轻而易举地去除干净。她特别发出安全预警：市面上琳琅满目的家用“速效美白牙膏”大多添加了极高浓度的粗糙研磨剂，长期使用犹如用砂纸抛光，不仅破坏脆弱的天然牙釉质表面，更会诱发不可逆的牙本质敏感。 - **隐匿的根尖脓肿**：剧烈牙痛在解剖层面往往对应着透明模型中所示的根尖红色炎性肉芽肿或骨破坏区。 - **色素沉着分类**：吸烟、茶渍、咖啡渍属于外源性着色，洁牙抛光即可迅速清除，无需强行美白。 - **美白牙膏风险**：过度依赖强效美白牙膏极易因高研磨度（RDA 超标）磨损牙釉质，导致牙齿永久性受损变脆。 ### [01:21:59](https://www.youtube.com/watch?v=p3fSwd1cF08&t=4919s) 牙齿去角质的代价与专业美白的选择 很多人把牙齿美白或磨砂类清洁产品当成给牙齿“去角质”，但牙齿与皮肤有着本质区别：牙釉质一旦磨损，便永远无法再生。如果长期过度去除牙齿表层的牙釉质，问题会接踵而至。最直接的后果就是牙齿敏感；更讽刺的是，随着半透明的牙釉质被磨薄，其下方天然偏黄的牙本质（Dentin）会直接透显出来，原本追求亮白的人反而会发现牙齿变得更黄，彻底适得其反。 谈到真正有效且安全的美白，维多利亚·桑普森（Dr. Victoria Sampson）强烈呼吁必须寻求专业牙医的操作，切勿在网上随手购买非处方（OTC）的美白产品。市面上的自行美白产品往往浓度配比失当，极易对牙釉质和牙龈造成不可逆的严重化学灼伤与物理损伤。即便在专业牙科领域，各类美白剂的品质也是参差不齐。她诊所选用的是一款名为 Enlighten 的温和美白系统，其单日美白过程对牙齿造成的酸性负担仅相当于喝了一罐可口可乐；连续使用五至六天，整体影响完全处于安全可控范围内，不会对牙齿结构造成实质损害。 ### [01:23:13](https://www.youtube.com/watch?v=p3fSwd1cF08&t=4993s) 牙菌斑居家清理与冲牙器的误区 针对“能否不找洗牙师（Dental Hygienist）、自己在家彻底清除牙石牙菌斑”的疑问，答案是否定的。史蒂文·巴特利特（Steven Bartlett）提到自己最近刚买了一台家用冲牙器（水牙线），但总觉得水压太弱，完全没有诊所专业喷砂洁牙时那种“把整张嘴轰得干干净净”的强劲冲击感，甚至好奇为什么普通人不能买一台专业仪器放在家里。桑普森医生解释道，家用冲牙器之所以严格限制水流强度，是因为缺乏专业训练的普通人极易因操作失误而击伤牙龈软组织并破坏牙体表面，这极其危险。 不过，虽然无法在家用硬核器械物理剔除硬化的牙结石，但可以通过针对性的营养补充剂来抑制和延缓牙菌斑的形成，从源头上减少微生物薄膜的沉积，临床效果相当显著。 ### [01:24:00](https://www.youtube.com/watch?v=p3fSwd1cF08&t=5040s) 口腔益生菌：为微生态重构良性菌群 桌面上摆放着几款用于调节口腔菌群的益生菌产品。口腔益生菌的核心逻辑在于补充有益菌，只要日常饮食搭配合理并摄入充足的益生元，这些有益菌便能在口腔环境中扎根繁衍。现实中，许多人由于遗传或先天微生态缺陷，口腔内天生缺乏某些关键的有益菌株，精准补充因此显得尤为重要。 诊所会通过唾液微生态检测（如 Alice 唾液检测），详细分析患者缺失的有益菌种类，再量身定制益生菌补充方案： * **粉末状漱口水**：以干燥粉末形态保存益生菌，使用时取一茶匙与水混合激活活性菌体，在口腔内充分含漱后直接咽下。这种形式实现了“口腔微生态 + 肠道微生态”的双重兼顾。 * **咀嚼片**：制成片剂形式，放入口中嚼碎后吞服，使用极其便捷，适合日常随时补充口腔原生良性菌。 ```mermaid flowchart TD accTitle: 口腔益生菌补充与调理流程 accDescr: 展示从微生态检测到定制化补充口腔益生菌并惠及肠道的完整闭环。 subgraph Detect ["精准检测"] A["唾液微生态检测"] --> B["分析缺失的有益菌株与基因特征"] end subgraph Intervene ["定向补充"] B --> C1["粉末型益生菌漱口水<br/>(兑水激活含漱)"] B --> C2["咀嚼型益生菌片剂<br/>(嚼碎后吞服)"] end subgraph Benefit ["微生态平衡"] C1 --> D["定植口腔建立健康屏障"] C2 --> D C1 --> E["咽下滋养肠道菌群"] D --> F["抑制有害菌与牙菌斑滋生"] end ``` ### [01:25:12](https://www.youtube.com/watch?v=p3fSwd1cF08&t=5112s) 被低估的护齿神器：吸管的物理旁路效应 当被问及“今天讨论中最重要的遗漏点”时，桑普森医生强调了一个极其日常却被绝大多数人忽视的工具——**吸管（Straws）**。吸管在防御酸蚀和糖分侵害方面扮演着关键角色。饮用酸性强、含糖量高或容易着色的深色饮品时，使用吸管能让液体绕过所有牙齿（Bypass teeth），直接进入咽喉后部并被吞咽。 这一物理旁路机制能极大降低牙齿发生龋坏、酸蚀磨损以及色素沉积的概率。桑普森医生坦言自己也是个普通人，偶尔也会想喝杯可乐或享用酒精饮品，但只要不是品鉴红酒，她都会严格使用吸管饮用。当然，对于有益于口腔微生态的物质（如益生菌液），则应当充分与牙齿和口腔黏膜接触，无需使用吸管。 ### [01:26:08](https://www.youtube.com/watch?v=p3fSwd1cF08&t=5168s) 吸烟与电子烟：无声破坏微生态的隐形杀手 吸烟与电子烟（Vaping）对口腔微生态的打击是毁灭性的，其危害机制主要体现在以下三个层面： 1. **诱发口干症（Dry Mouth）**：烟雾严重破坏唾液腺分泌，唾液分泌量骤减导致其天然的缓冲、再矿化与抗菌保护屏障荡然无存。 2. **血管收缩与“假性健康”假象**：尼古丁会导致口腔黏膜毛细血管剧烈收缩，阻碍正常的局部血液微循环。许多长期吸烟者即便已经患上严重的牙周病，其牙龈也几乎不会出血。这种缺血状态掩盖了牙周红肿发炎的警示信号，使患者误以为自己牙齿十分健康，实则牙槽骨与支持组织正在无声崩解。 3. **重度牙周病的头号危险因素**：大量流行病学证据表明，吸烟与牙周炎具有强烈的因果关联，是诱发不可逆牙齿松动脱落的最核心诱因之一。 ### [01:26:54](https://www.youtube.com/watch?v=p3fSwd1cF08&t=5214s) 重新定义现代牙科：The Health Society 诊所与微生态解码 面对想要全面了解自身口腔菌群并寻求解决方案的患者，桑普森医生介绍了她于一年半前在伦敦市中心创办的多学科口腔医疗中心——**The Health Society**。诊所的创立宗旨是“把口腔重新放回人体整体之中”（Put the mouth back into the body）。传统的牙科体验通常冷冰而机械——牙医只会宣布“你有两颗蛀牙、牙周发炎，回家好好刷牙”，随后进行钻牙补牙。而现代功能牙科学致力于为患者彻底“解码牙科”。 诊所整合了口腔微生态唾液检测、血糖监测、维生素 D 水平检测，甚至引入了红外桑拿舱与专业营养师团队，多维度协作调理身体内环境。对于身处加拿大、澳大利亚、新西兰或美国等地的海外受众，微生态检测套件正在全球逐步推开。桑普森医生建议，无法亲临伦敦的患者可以先通过线上唾液套件了解自身的有害菌分布、遗传突变倾向及潜在炎症水平，再拿着详尽的数据寻找认可功能性医学理念的牙医制定方案。 ### [01:29:06](https://www.youtube.com/watch?v=p3fSwd1cF08&t=5346s) 终极拷问：生命中最重要的关系 按照播客节目的经典收官传统，上一位飞行嘉宾留下了一个匿名问题：“**你生命中最重要的一段关系是什么？为什么？**” 桑普森医生沉思后给出答案：是她的**母亲**。她将母亲视为自己人生中最大的导师、最忠实的拉拉队员和最坚强的后盾。虽然母亲对子女要求极为严厉，但正是这种严格塑造了如今的她。她坚信，如果一个人无法与自己的母亲维系良好关系，便很难在社会中与他人建立健康深厚的联结；是母亲教会了她什么是尊重，以及如何在人际交往中立身处世。当巴特利特询问其家庭背景时，桑普森医生透露她的母亲是伊朗人，而父亲是一位美籍法国人。多元文化的严厉关爱，最终铸就了她坚韧的职业底色。 ### [01:30:18](https://www.youtube.com/watch?v=p3fSwd1cF08&t=5418s) 重新将口腔融入身体：口腔医学与系统医学的整合愿景 当被问及如果有一根魔法棒、最希望改变医疗行业的什么现状时，维多利亚·桑普森医生（Dr. Victoria Sampson）毫不犹豫地表示，她最大的愿望是“让口腔真正重新回到身体当中”（the mouth is put back into the body），促成口腔医学与现代临床医学的深度全面整合。在她的构想中，未来的常规看牙不再局限于补牙或洗牙，患者走进牙科诊所进行一次唾液检测，就能提前筛查出心脏病、糖尿病等全身性代谢与心血管隐患，牙医则能第一时间将患者转诊给糖尿病专家或专科医生进行干预。桑普森医生的另一个愿景是改变大众对体检的认知惯性，让唾液检测普及化，让人们意识到抽血绝非窥探体内健康状况的唯一窗口，唾液同样是一面极为敏感、信息量庞大的镜子。 ```mermaid flowchart TD accTitle: 牙医诊所唾液检测与全身医疗联动流程 accDescr: 展示了患者在牙科诊所通过唾液检测筛查全身健康隐患并转诊给专科医生的闭环链路。 subgraph DentalVisit["牙科常规诊疗"] A["常规牙科面诊"] --> B["无创唾液微生态检测"] end subgraph EarlyDetection["全身隐患早期预警"] B --> C{"生物标志物分析"} C -->|"心血管风险"| D["心血管专科转诊"] C -->|"代谢异常"| E["糖尿病专科转诊"] C -->|"炎症失衡"| F["全科与免疫干预"] end subgraph CompoundingHealth["长期健康复利"] D & E & F --> G["防患于未然的综合健康管理"] end ``` 这段对话让主持人 Steven Bartlett 深受触动与启发。他感慨道，自己在播客中采访过无数顶级医学专家，探讨过大脑、不孕不育、肠道微生态等形形色色的前沿课题，却从未有人像桑普森医生这样，带领大家通过口腔微生态这扇“身体的前门”来审视全身的整体健康全貌。很多时候，人们只需要多了解一点底层机制，就足以在生活中做出微小却关键的改变。口腔健康、微生态平衡与大脑机能紧密交织，这些细微的生活习惯随着时间推移会产生巨大的下游复利效应，“要么为我们带来增益，要么对我们产生反噬”。Steven 盛赞桑普森医生的开创性工作不仅拨开了认知迷雾、点亮了口腔微生态领域，更坚信在未来的十年里，她所传播的理念和推动的研究必将深远改变数以百万计人的健康与生活轨迹。 - **口腔与医学割裂的弥合**：推动临床转诊闭环，打破牙科仅关注牙齿与牙龈的孤岛状态，将其视为全身性疾病早期筛查的前哨站。 - **诊断方式的革新**：呼吁公众与医学界重视唾液无创检测的巨大潜力，打破“只有血液才能反映全身健康”的传统思维。 - **微小习惯的复利价值**：日常口腔微生态的维护不仅能预防龋齿和牙周炎，更是对抗全身慢性低度炎症、阿尔茨海默病及心血管风险的核心防线。 --- ### [01:32:14](https://www.youtube.com/watch?v=p3fSwd1cF08&t=5534s) 复合效应的力量：Steven 揭幕“1% 日记”与节目尾声 在对话落幕之际，Steven 转向专属的社群听众，分享了一款筹备已久的新产品——“1% 日记”（1% Diary）。他坦言在自己的办公室内部，被提及最频繁的核心哲学就是“1% 思维”（the 1% mindset）。这不仅是一套思维模式和行为习惯，更彻底改变了他的人生轨迹，也是这档播客节目能够取得如今影响力的根本驱动力所在。 Steven 强调，人生的真正蜕变从来不依赖戏剧性的剧烈动荡或一夜暴富式的速成，而是源于微小、持续、日复一日的行动所产生的复合收益。为了将这种理念转化为切实可行的工具，团队历时整整两年潜心打磨出这本实体日记，内部融入了精美图文、灵感启发、动机引导以及互动式追踪模块，旨在帮助使用者精准锁定每天能进步 1% 的微习惯，保持高度专注，并逐步建立终身受益的一致性。该日记首批限量发行，听众可通过官方等待名单登记获取，节目随后在轻松悠扬的尾声音乐中正式收尾。 - **1% 心态的核心逻辑**：拒绝短期功利主义与激进转变，依托每天持续微小的正向积累，在时间维度上撬动惊人的复利改变。 - **产品的实用设计**：历经两年设计，内置可视化目标拆解、每日习惯追踪与互动式激励板块，辅助用户养成高度自律的生活节奏。 - **获取途径与限量发行**：首批日记数量有限，官方排队名单设立于专属通道，供追求自我迭代的听众预约。 ## Notable quotes > [02:01](https://www.youtube.com/watch?v=p3fSwd1cF08&t=121s) the mouth is the gateway to the rest of the body — Dr. Victoria Sampson > [07:47](https://www.youtube.com/watch?v=p3fSwd1cF08&t=467s) 你去看内科医生，他们会为你验血；那为什么你去看牙医，牙医却不为你化验唾液呢？ — 瑞典卡罗林斯卡学院教授 > [18:23](https://www.youtube.com/watch?v=p3fSwd1cF08&t=1103s) the more teeth the better — Dr. Victoria Sampson > [22:58](https://www.youtube.com/watch?v=p3fSwd1cF08&t=1378s) the only non-shedding surfaces in the whole body — Dr. Victoria Sampson > [26:14](https://www.youtube.com/watch?v=p3fSwd1cF08&t=1574s) 我的牙龈每次刷牙都会出血，但这很正常 — 患者常见误区 > [01:16:00](https://www.youtube.com/watch?v=p3fSwd1cF08&t=4560s) Spit, don't rinse — Dr. Victoria Sampson > [01:13:49](https://www.youtube.com/watch?v=p3fSwd1cF08&t=4429s) 根本原因是你的狗狗们患有牙周病，要想彻底治愈你的口臭，必须先治好它们。 — Dr. Victoria Sampson > [01:26:54](https://www.youtube.com/watch?v=p3fSwd1cF08&t=5214s) Put the mouth back into the body — Dr. Victoria Sampson > [01:29:06](https://www.youtube.com/watch?v=p3fSwd1cF08&t=5346s) 你生命中最重要的一段关系是什么？为什么？ — 飞行嘉宾 ## Mentioned Dr Victoria Sampson, Steven Bartlett, The Health Society Labs, The Diary Of A CEO, British Dental Journal, World Health Organization (WHO), SAGE (英国紧急情况科学咨询小组), James Nestor, Weston A. Price, Tim Spector, Karolinska Institute, ZOE, Wrigley (箭牌), Enlighten, Super Teeth Soft Floss, Super Teeth Toothpaste, Super Teeth Dental Prebiotic, Bio.Me Supplement, BioMin Toothpaste, DR. HEFF'S Supplement, 1% Diary, Fusobacterium nucleatum (具核梭杆菌), Porphyromonas gingivalis (牙龈卟啉单胞菌), Gingipains (牙龈蛋白酶), aMMP-8 (活化基质金属蛋白酶-8) ## Video description Dr Victoria Sampson is an award-winning functional dentist, researcher, and founder of the multidisciplinary oral health centre, The Health Society Labs. She is also the first dentist in the world to link gum disease with worse COVID complications. 00:00 Intro 02:02 The Oral Microbiome 03:22 What Impacts Our Oral Microbiome? 04:01 2 Million Bacteria in Your Mouth 05:14 How Many People Have Oral Diseases? 06:47 Body Diseases Linked to Oral Microbiome 08:33 Steven Adjusting Chair? 10:46 Research Linking COVID-19 and Oral Hygiene 13:06 Can Your Oral Microbiome Kill You? 13:55 How Food Shapes Your Mouth 17:03 What’s a Wisdom Tooth? 18:22 Do Wisdom Teeth Need Removal? 19:07 Why Do We Need Dentists If Ancestors Had Good Teeth? 20:33 Is Everyone’s Microbiome Massively Different? 22:22 How Oral Health Improves Overall Health 24:22 Can Swallowing Saliva Make You Sick? 26:16 Inflammation and the Oral Microbiome Link 28:18 Rheumatoid Arthritis Strongly Linked to Oral Health 30:43 Heart Disease and the Oral Microbiome 33:30 How Oral Bacteria Filters Through Your Body 33:48 Erectile Dysfunction Linked to Oral Hygiene 35:56 Emerging Research: Breast Cancer and Oral Microbiome 39:53 Green Tea Benefits for Oral Health 41:12 Impact of Coffee on Oral Health 42:14 Effects of Hot Drinks & Sugar on Teeth 44:02 Link Between Brain Health & Alzheimer’s 50:39 Can Mental Health Be Seen in the Mouth? 51:40 Spotting Eating Disorders Through Oral Health 52:18 How Stress Affects Your Oral Health 53:54 Mouth vs. Nose Breathing: Health Impacts 57:36 Higher ADHD Risk in Mouth-Breathing Children 58:31 Kissing and Bacteria Transmission 59:32 Oral Sex and the Oral Microbiome 01:01:55 Switching to Steven - Transition 01:02:35 Oral Health and Fertility 01:07:01 Ad Break 01:08:00 Study Results on Oral Health 01:16:59 Best Time to Brush Your Teeth 01:18:05 Good vs. Bad Oral Products 01:26:46 Should You Spit or Rinse After Brushing? 01:31:16 Whitening Products: Do They Work? 01:34:20 Importance of Drinking Through Straws 01:35:13 Smoking and Vaping Effects on Oral Health 01:37:58 Last Guest Question Follow Dr Victoria: Instagram - https://g2ul0.app.link/BYodSLgymOb Website - https://g2ul0.app.link/1CuFnflymOb 🤐 👀 Psstt! Are you ready to finally reach your goals? - you can join the exclusive waitlist NOW for the limited run of our brand new 1% Diary here - https://bit.ly/1-Diary-Waitlist-YT-ad-reads Saliva Test Kit: https://g2ul0.app.link/0HibFujjrOb You can learn more about the products mentioned, here: Super Teeth Soft Floss: https://g2ul0.app.link/GH0TGntymOb Super Teeth Toothpaste: https://g2ul0.app.link/pU20AczymOb Super Teeth Dental Prebiotic: https://g2ul0.app.link/7rjRJUAymOb Bio.Me Supplement: https://g2ul0.app.link/UMvwbXDymOb BioMin Toothpaste: https://amzn.to/3Aw6J00 DR. HEFF´S Supplement: https://amzn.to/3YWE3Xf Get access to exclusive Diary of a CEO content: https://www.youtube.com/channel/UCGq-a57w-aPwyi3pW7XLiHw/join Sponsors: ZOE - http://joinzoe.com with code STEVEN10 for 10% off [Source](https://www.youtube.com/watch?v=p3fSwd1cF08)

[2:01] Dr. Victoria Sampson: the mouth is the gateway to the rest of the body [7:47] 瑞典卡罗林斯卡学院教授: 你去看内科医生，他们会为你验血；那为什么你去看牙医，牙医却不为你化验唾液呢？ [18:23] Dr. Victoria Sampson: the more teeth the better [22:58] Dr. Victoria Sampson: the only non-shedding surfaces in the whole body [26:14] 患者常见误区: 我的牙龈每次刷牙都会出血，但这很正常 [76:00] Dr. Victoria Sampson: Spit, don't rinse [73:49] Dr. Victoria Sampson: 根本原因是你的狗狗们患有牙周病，要想彻底治愈你的口臭，必须先治好它们。 [86:54] Dr. Victoria Sampson: Put the mouth back into the body [89:06] 飞行嘉宾: 你生命中最重要的一段关系是什么？为什么？

[8:53] Dr. Victoria Sampson: Patients who had gum disease were nine times more likely to have COVID complications... Most didn't die from the virus itself; they died from secondary bacterial super-infections like pneumonia, driven by oral bacteria traveling straight from the mouth to the lungs. [28:18] Dr. Victoria Sampson: When I treated the gum disease properly and aggressively... her gums healed, but more importantly, her rheumatoid arthritis got better to the point where she was actually able to get off steroids and medication and be able to walk again.

[0:00] Is there a link between our oral health [0:01] and our fertility? [0:02] Yes. This is some of the newest research [0:04] that's coming out and they found that [0:06] over 90% of men who wasn't able to [0:08] conceive with their partners had an oral [0:10] disease. With those who got treated, [0:11] there was a 70% improvement in [0:13] pregnancy. Now, research has also found [0:15] that if a woman has gum disease, it [0:16] takes them 2 months longer to conceive. [0:19] And I'm the only one who's talking about [0:20] it. [0:21] And who are you? [0:22] I am the saliva queen. [0:23] Dr. Dr. Victoria Samson is the [0:25] trailblazing dentist [0:26] whose datadriven research has uncovered [0:28] the shocking link between our mouths [0:30] and some of the world's most destructive [0:31] conditions. More than 90% of diseases [0:34] can be traced back to our microbiomes. [0:36] And we now understand that having an [0:37] imbalanced oral microbiome increases [0:39] your risk of high blood pressure, heart [0:41] disease, Alzheimer's, rheumatoid [0:43] arthritis, and even men who have gum [0:45] disease are 2.85 times more likely to [0:47] have erectile dysfunction. [0:48] Really? [0:49] Yeah. And then another study also showed [0:51] there's oral bacteria that can make [0:53] cancer more aggressive and harder to [0:55] treat as well. [0:55] But what is it that causes all of this? [0:57] Poor oral hygiene, sugar, stress, but [0:59] also some of us genetically will have [1:01] mutations which can cause disease. But [1:04] there's ways to fix it. For example, I [1:05] had a patient who had terrible arthritis [1:07] and terrible gum disease. And when I [1:09] treated the gum disease, her rheumatoid [1:10] arthritis got better to the point where [1:12] she was actually able to walk again. [1:14] Wow. [1:15] Yeah. [1:15] So, let's talk about what we can do [1:16] about it. Is there any time where I [1:18] shouldn't brush my teeth? Do I spit or [1:20] rinse after I've brushed my teeth? [1:21] Chewing gum, coffee, mouthwash, good or [1:24] bad for me? [1:25] Let's go through all of that. So, [1:27] weirdly, [1:29] this has always blown my mind a little [1:31] bit. 53% of you that listen to the show [1:33] regularly haven't yet subscribed to the [1:35] show. So, could I ask you for a favor [1:37] before we start? If you like the show [1:38] and you like what we do here and you [1:40] want to support us, the free simple way [1:41] that you can do just that is by hitting [1:43] the subscribe button. And my commitment [1:45] to you is if you do that, then I'll do [1:47] everything in my power, me and my team, [1:48] to make sure that this show is better [1:50] for you every single week. We'll listen [1:52] to your feedback. We'll find the guests [1:53] that you want me to speak to, and we'll [1:55] continue to do what we do. Thank you so [1:57] much. [2:01] Dr. Victoria Samson, what is the mission [2:05] that you're on? [2:07] Um, my mission is to show people that [2:09] the mouth is the gateway to the rest of [2:11] the body. And if they really want to [2:13] achieve full body health, it starts with [2:14] the mouth first. [2:16] I've never heard of the term oral [2:18] microbiome [2:19] really until I met you and went through [2:22] all of your work and your research and I [2:25] think many people listening to this now [2:26] also probably aren't familiar with that [2:28] term or and also the importance of that [2:30] term. So if you had to make a case to [2:32] someone like me who's really unfamiliar [2:33] with this subject as to why it's so [2:35] important from a very topline [2:37] perspective, [2:38] what would you say? I think everyone [2:41] knows that their gut has a microbiome. [2:43] And for the past 10 years, we've always [2:44] talked about how you can change your [2:46] diet, probiotics, prebiotics for the gut [2:48] microbiome. But what a lot of people [2:50] don't understand is that the oral [2:52] microbiome is the second largest and [2:54] most diverse microbiome after the gut. [2:56] It's also a lot easier to change and [2:58] actually it's been shown to have a [3:00] massive impact on general health. So, [3:02] uh, having an imbalanced oral microbiome [3:04] increases your risk of oral diseases [3:07] like gum disease and decay, but also can [3:09] increase your risk of other systemic [3:11] diseases like high blood pressure, heart [3:13] disease, infertility, Alzheimer's. Um, [3:16] and it's something that is so easy to [3:18] manage and balance. [3:20] How many people does this impact and how [3:22] many people is it relevant to? So, an [3:24] understanding of my or oral microbiome [3:26] is going to help me in a number of ways [3:28] as it relates to my overall health. But [3:29] how many people does it really really [3:31] have an impact on? [3:33] I think it depends on what you're trying [3:34] to get out of the oral microbiome [3:36] testing. Um, I would argue that it [3:39] benefits everyone. We all have teeth. We [3:41] all have mouths. Um, and everything that [3:44] we do, every time we breathe, we eat, we [3:46] drink, we kiss, uh, we are impacting our [3:49] oral microbiome every single time. And [3:51] then every time we swallow or we breathe [3:53] that bacteria that is putting into our [3:56] mouth will travel elsewhere to the rest [3:57] of the body and cause problems [3:58] elsewhere. [3:59] You said it's the second biggest [4:01] microbiome in the body. [4:02] Yeah. [4:02] How many bacteria are in my oral [4:04] microbiome? [4:05] So you have 700 approximately 700 [4:08] different bacteria which make up two [4:09] billion bacteria overall. And what's [4:11] also very weird about the oral [4:13] microbiome compared to any of the other [4:14] microbiomes is that you've got lots of [4:17] different environments or niches within [4:19] the same mouth. So, if you think about [4:20] the bacteria that would like to live [4:23] under the gums or at the back of your [4:25] throat or on your teeth, they're all [4:28] very different environments. Some are [4:29] hot, cold, you know, wet. And so, you've [4:32] got lots and lots of different parties [4:34] of bacteria within the same microbiome [4:36] in the mouth. [4:37] Okay. And you mentioned a second ago [4:40] that things like kissing, breathing, [4:42] swallowing have an impact on my oral [4:44] microbiome. [4:45] Yes. [4:45] In a significant way that I need to know [4:47] about. [4:48] Uh, yes. So, it's more about how often [4:50] you're doing those certain habits. So, [4:52] you know, for example, with kissing, the [4:54] research has shown that you need to kiss [4:56] more than 11 times a day for you to be [4:58] sharing the same bacteria or microbiome [5:00] as your partner. Um, but also even the [5:02] habits that we have, um, the air quality [5:04] that we have, everything will dictate [5:07] the environment that our mouths are [5:09] living in and therefore what bacteria [5:11] will live in our mouths. And on the [5:13] subject of oral diseases and things like [5:15] tooth decay, how many people are [5:17] impacted globally by oral diseases? [5:21] So the World Health Organization has [5:23] come out um saying that 3.5 billion [5:25] people have some sort of oral disease. [5:28] They've also found that 10% of our world [5:31] population are suffering from severe gum [5:33] disease which makes gum disease one of [5:36] the most prevalent inflammatory [5:37] conditions um in the whole body. this [5:40] conversation around the oral microbiome. [5:41] Have you seen it developing over the [5:43] over recent years, have you seen it [5:45] become more sort of pertinent to people [5:47] in society? [5:49] Massively. I think I've been doing this [5:50] for for years. It's been something that [5:53] I've loved. Um, and no one really knew [5:55] what I was talking about most of the [5:56] time. They all thought I was a bit of a [5:57] dreamer. Even dentists, patients, they [5:59] all thought, okay, well, doesn't really [6:01] matter, does it? But in the last year or [6:03] two, I've had people traveling from all [6:05] around the world just to get their oral [6:07] microbiome tested to understand more [6:09] about what's going on in their body. And [6:10] I think we're seeing a shift in the [6:12] generations in terms of this new [6:14] generation want to understand their [6:16] health a lot more. So we're all sitting [6:18] there wearing, you know, trackables, [6:20] wearables. We're, you know, calculating [6:22] how much sleep we have, how much we're [6:23] eating. And for uh now we're actually [6:26] also wanting to understand our oral [6:28] health. So that trust between a dentist [6:31] and the patient is not necessary [6:34] anymore. We want to actually understand [6:35] what's going on in their mouths and [6:37] actually, you know, be able to track [6:38] things, see what bacteria we have, how [6:40] much inflammation we have, our risk of [6:42] diseases, and what we can do to change [6:44] that. [6:45] Last question before I ask you a more [6:47] sort of personal question about [6:48] yourself. Um, what other diseases in my [6:50] body or sort of implications in my body [6:52] are linked and can be traced back to the [6:54] oral microbiome? We now understand that [6:57] more than 90% of diseases can be traced [7:00] back to an imbalanced microbiome. Uh if [7:02] we zone into just the oral microbiome, [7:05] it's got connections with infertility, [7:08] heart disease, diabetes, Alzheimer's, [7:10] rheumatoid arthritis. Um and the list [7:14] goes on. Erectile dysfunction. Um and [7:17] what's also very interesting going back [7:18] to your question about you know is there [7:20] been a new interest in this in the last [7:22] few years we've actually been able to [7:25] show that there is a strong connection [7:27] and causation between the oral [7:29] microbiome and general diseases whereas [7:31] prior to maybe 5 years ago there was a [7:34] lot of kind of is this correlation is it [7:36] just that okay there's the same risk [7:38] factors with gum disease and with heart [7:40] disease for example smoking and now [7:42] we're actually seeing that no it's not [7:44] just correlation there is strong [7:46] causation between the two. [7:47] And who are you? [7:49] Um, I am Victoria Samson. I'm a dentist. [7:53] Um, I do a lot on the oral microbiome. [7:56] Um, people call me the saliva queen. [7:58] That's my name on the streets. [8:00] And what's your sort of what [8:01] professional experiences and education [8:04] have brought you here today? And how [8:06] long have you been doing that? How many [8:07] mouths and how much saliva have you [8:08] seen? Give me a a sort of a a big view [8:11] on the the wealth of experience you have [8:12] on this subject. Um so originally I [8:16] trained as a dentist. Um and that's six [8:19] years of training. Um I would say I was [8:21] a pretty traditional conventional [8:24] dentist as I graduated. Um I'd done some [8:27] training um at the Karolinska Institute [8:29] during my university and the the [8:32] Karolinska Institute is the best dental [8:34] school in the world. Um but they're very [8:36] focused on the mouthbody connection on [8:39] testing saliva. Um, and what they [8:41] thought was that, you know, you go to [8:43] your doctor and you have a blood test. [8:44] Why don't you go to your dentist and get [8:45] a saliva test? So, from even dental [8:48] school, I had this in the back of my [8:49] mind, but I still didn't have the [8:52] training. And so, I just became a [8:53] dentist. Um, I was working half NHS, [8:56] half private, and then as time evolved, [8:59] I then, um, shifted to fully private. [9:02] Um, and then when COVID happened, um, I [9:05] started doing a lot of research and all [9:06] the dental practices were closed across [9:09] the country. Um, and I thought that was [9:11] crazy because basically the government [9:13] was saying dental practices, uh, or [9:15] dentistry is not a necessity. So, uh, I [9:18] thought that was insane. And so I [9:21] decided to do a lot of research and I [9:23] wrote a paper which was connecting, um, [9:26] oral health with poor with CO [9:28] complications. So what we found was that [9:30] patients who had poor oral health or gum [9:32] disease were at a much higher risk of [9:34] COVID complications. Um and then that [9:38] evolved into me doing some studies with [9:39] universities and hospitals. But the [9:42] issue was that we couldn't go into um [9:45] hospitals and check people's teeth and [9:47] gums because they had CO. So instead [9:49] what we did was we would collect their [9:50] saliva and we would take it to the lab [9:53] and we had this beautiful snapshot of [9:55] what was going on in a patient's mouth [9:57] at that moment in time just from their [9:59] saliva. So we did a lot of research and [10:01] we found that uh COVID sufferers or [10:04] patients who had gum disease were nine [10:06] times more likely to have COVID [10:07] complications. But also what I took from [10:10] that was that why aren't we using saliva [10:12] you know more regularly? Why don't we [10:14] use this in more commercial aspect and [10:16] for our patients. So after that I [10:19] devoted a lot of time into developing [10:21] oral microbiome testing. We had gut [10:24] microbiome testing. you've got urinary [10:26] microbial, you've got every single [10:27] microbiome has a test, but the oral [10:29] microbiome didn't really have one. So, I [10:32] built one of the first oral microbiome [10:33] tests in Europe um and that was a couple [10:35] of years ago and then now have come out [10:38] and uh kind of left and created my own [10:41] one um about a couple of weeks ago. [10:45] That research you mentioned, [10:46] specifically the research paper which [10:48] was titled, could there be a link [10:49] between oral hygiene and severity of co [10:52] infections [10:53] was the first research paper to link gum [10:55] disease with worse co complications and [10:59] I was reading that it was the most cited [11:02] research paper by the one of the sort of [11:05] dentistry publications. [11:06] Yeah. Yeah. So the British dental [11:08] journal is one of the most cited and [11:09] viewed articles. Um and what it also [11:12] helped do was um the World Health [11:14] Organization and SAGE picked that up and [11:17] they said, "Oh, wait a second. I think [11:19] that oral health is really important for [11:21] general health and also we should reopen [11:23] dental practices." So this also paved [11:25] the way for dental practices reopening [11:27] later on. [11:28] What's going on there? Can you explain [11:29] that to me like a 10-year-old? So if I [11:32] have a bad or a unhealthy oral [11:35] microbiome, I'm nine times more likely [11:38] to end up in ICU with CO complications. [11:41] What what's the link? [11:43] So there's a few. So the first one is [11:45] inflammation. So CO we know um it [11:49] releases a lot of inflammatory markers. [11:51] So it's what we call the cytoine storm. [11:53] So it's essentially the storm of lots [11:55] and lots of inflammatory markers. And [11:57] gum disease separately um is essentially [12:00] inflammation of the gums. And so what [12:02] gum disease does is it releases lots of [12:04] inflammatory markers from the mouth [12:06] elsewhere to the rest of the body. So [12:07] then when you add those together and you [12:09] have your cytoine storm from COVID and [12:11] you've got your inflammatory markers [12:13] from gum disease, it's just adding [12:15] petrol to the fire. So you're just [12:16] making that cytoine storm even worse. [12:19] Um but then on the separate side, it's [12:20] also bacteria. So if you look at the um [12:23] autopsies and the research of CO uh [12:26] patients um most of them didn't die from [12:28] the virus itself. You no one really died [12:30] from COVID 19. They died from [12:32] complications. So the number one [12:34] complication was actually a bacterial [12:36] infection. So imagine your body you've [12:38] got COVID you are really unwell and your [12:41] immune system is on absolute overdrive. [12:44] This is the prime time for bacteria to [12:46] come into your body and to cause what we [12:48] call a bacterial super infection. And so [12:50] actually when you looked at the [12:51] autopsies of a lot of these patients, [12:53] they had oral bacteria from their mouth [12:56] traveling to their lungs and causing [12:58] bacterial super infections which would [13:00] result in things like pneumonia. And [13:02] that's actually the cause of death for [13:03] most patients. [13:05] You don't really think that your oral [13:07] microbiome can be fatal. It can kill [13:10] you. [13:11] No. And even I think as a dentist we [13:15] weren't really taught how important [13:17] bacteria was or how important the mouth [13:20] was for the rest of the body. Uh the [13:22] number the only one that we ever learned [13:24] um and a lot of people would know this [13:26] one is that if you um have heart surgery [13:30] you can't actually have a hygiene for [13:32] about 6 months after the heart surgery. [13:34] A dental hygiene. [13:35] Yes. And the reason for that is because [13:37] you're at a very high risk risk of [13:39] something called infective endocarditis. [13:41] So this is oral bacteria which travels [13:43] down to a faulty heart valve um and can [13:46] actually cause death. Um so we know that [13:48] but we never really look at it for other [13:51] diseases or other problems. [13:53] I want to um I want to take a step back [13:55] before we go through the links between [13:57] our oral microbiome and all of these [13:59] diseases. But also I really want to also [14:00] talk about how what we can do about it [14:02] because I've got so many questions [14:03] around it. I've got all of these [14:05] products down below my chair from [14:06] mouthwashes to toothpaste to all these [14:08] kinds of things which I want to talk [14:09] about as well. But just taking a step [14:11] back to something that one of my guests [14:12] previously was telling me about. I think [14:14] it was James Nester. He was telling me [14:16] that the the mouth itself and the jaw [14:19] because of processed foods is an [14:22] abnormal shape. And when I say abnormal, [14:24] I mean um in relation to how it was [14:26] supposed to develop because we're eating [14:28] so many processed foods which aren't, [14:30] you know, which are designed to be easy [14:31] to chew. the mouth itself and the jaw [14:34] have changed. Is there any truth in [14:35] that? [14:36] Yeah, 100%. So, there was a man called [14:39] Western Price um and he was a dentist [14:42] and he basically suspected that and he [14:44] was like, "This is strange. Why is it [14:46] that um people who are in more [14:49] industrialized and westernized areas [14:52] have higher levels of decay and they [14:53] have loads of crowding?" So, they had [14:55] basically lots of crowding of the teeth [14:58] um and sper jaws. And so he basically [15:00] traveled around the world and he looked [15:02] at lots of different um tribes, [15:05] villages, countries and he compared the [15:08] teeth of uh for example twins. One twin [15:11] would be in a very industrialized [15:13] westernized area and the other one was [15:15] not. And what he found was that in the [15:18] twins who were in these [15:19] non-industrialized areas, they were [15:21] eating harder foods. Uh they were having [15:24] less sugar and actually their jaws [15:26] developed a lot better. So they didn't [15:27] have crowding. They had perfect teeth [15:29] actually and they had no decay compared [15:32] to the children or the the twins who are [15:34] in more industrialized areas and it is [15:37] because our food now has become so [15:39] processed. A lot of children are not [15:41] having hard foods. Um and so we don't [15:44] develop the jaws and the muscles at an [15:46] early age and so the teeth haven't [15:48] changed size. The teeth are exactly the [15:49] same size as they were previously. But [15:51] what we're seeing is that those teeth um [15:54] don't have any space to grow anymore and [15:55] that's when we're getting crowding. And [15:57] can you see that in any of those models? [15:59] So, uh, yeah, in this model you can [16:02] actually see at the very back. So, a lot [16:03] of people will have wisdom teeth. Um, [16:05] and, uh, one of the biggest issues at [16:08] the moment is that a lot of people have [16:09] impacted wisdom teeth. So, this is [16:11] basically, imagine your teeth are all [16:13] upright. Your wisdom tooth is coming out [16:15] at a completely horizontal angle and [16:17] it's pushing on the rest of the teeth. [16:19] It's an absolute nightmare as a dentist [16:21] to take out. It's even more of a [16:22] nightmare for a patient to have to [16:24] endure. But also we're seeing that there [16:26] are a lot more impacted wisdom teeth um [16:29] in the last 30 40 years than there were [16:31] previously [16:32] uh because the diets have changed. [16:33] Because the diets have changed a lot [16:34] more children are needing orthodontic [16:36] treatment now as well just because they [16:38] have crowded teeth. Teeth are [16:40] overlapping um and so they need braces [16:42] to straighten those teeth out. If you [16:44] think about cavemen, cavemen didn't have [16:47] dentists. They didn't have braces. They [16:49] didn't even use toothpaste. But they [16:51] didn't die from gum disease or decay or [16:54] crowded teeth. So, it's been something [16:56] in our industrialized or more kind of [16:59] westernized diet that has changed that. [17:02] My wisdom tooth is coming through on my [17:04] left side at the moment and I think [17:05] actually also my right side at the same [17:06] time. And I'm 32 years old now. So, I'm [17:09] like, why why the hell am I growing [17:10] teeth at 32 years old? I thought I was [17:12] on my way out or something. Um, so I got [17:14] two questions just before we crack on, [17:16] which is what the hell is a wisdom [17:17] tooth? Why is it called a wisdom tooth [17:18] and why is it coming through at 32 years [17:20] old? [17:21] Um, so we have teeth erupting at [17:24] different kind of times of our lives. So [17:28] usually you have your baby teeth, they [17:30] will erupt up to the age of about 6 or 7 [17:32] years old. Um, and then you have your [17:34] adult teeth coming through and usually [17:36] they will stop erupting around 12 years [17:38] old. Um, and then you have nothing. [17:40] You're chilling. You have nothing, [17:41] nothing, nothing nothing until about [17:43] maybe 18, 19 years old. And that's where [17:46] you start to get your wisdom teeth. The [17:49] name behind wisdom teeth from what I [17:51] understand is because it's it erupts [17:54] when you're older. It's when you have [17:55] more wisdom and you're more wise. So I'm [17:57] wise now. [17:57] So you're just very wise. [17:59] Okay, makes sense. [18:00] And so some people will get it at 18. [18:03] Some people don't have any wisdom teeth. [18:05] Some people will have wisdom teeth which [18:06] erupt perfectly and are all completely [18:08] fine. and others will have their wisdom [18:10] teeth tooth erupt at 32 years old and [18:12] maybe be a little bit impacted or cause [18:14] problems. So, they're also very strange [18:18] teeth. Um, they're very unpredictable [18:20] the way that they are. [18:21] Is there any evolutionary basis for why [18:23] we need them? There must be some kind of [18:25] evolutionary reason for them. [18:27] Not that I understand. What is also [18:30] happening is that um apparently and this [18:32] is some research is that less people are [18:34] having wisdom teeth because more [18:37] children or or adults are getting their [18:39] wisdom teeth taken out and as evolution [18:42] goes um eventually some people are [18:45] actually not having wisdom teeth at all [18:46] because their ancestors haven't had [18:48] wisdom teeth so why would they have [18:49] wisdom teeth? Um but overall no there's [18:52] no real need for wisdom teeth. I never [18:56] like to take them out unless needed [18:58] because I mean more teeth [19:00] the better [19:00] the better and you never know if you [19:02] have to have something taken out and we [19:04] can use your wisdom teeth for something. [19:06] If I were to look at my ancestors from [19:09] 500 years ago, you said they don't have [19:11] dentists, they don't have toothpaste and [19:12] all those kinds of things. But you also [19:14] said they don't have tooth tooth decay. [19:16] Yeah. [19:16] Does that not therefore mean that I [19:19] shouldn't need a dentist and I shouldn't [19:20] need toothpaste or mouthwash or floss? [19:23] If you had a caveman diet, then [19:26] potentially you might not need [19:28] toothpaste, floss, or even a toothbrush. [19:31] Um, and there's a lot of argument as to, [19:33] you know, there's a lot of people out [19:34] there saying, you know, you don't need [19:36] to use any toothpaste, you don't need [19:37] floss, anything like that. And fine, go [19:40] ahead, do that. But only if you are [19:42] going to be eating, you know, meat, raw [19:45] meat sometimes, and you're only drinking [19:47] water and you're not having anything in [19:50] your diet which has any sugar or [19:52] carbohydrates in it. [19:53] I mean, doesn't that speak to what the [19:54] perfect diet is supposed to be? Can't we [19:56] tell what the perfect diet is supposed [19:58] to be by looking at the mouth? [19:59] Yeah. So, uh, another issue is that with [20:02] a lot of the food that we eat now, um, [20:05] they have a lot more sugar in them and [20:07] that will impact the acidity of your [20:08] saliva. And essentially what decay is [20:11] is, uh, you have sugar or you have some [20:14] sort of carbohydrates and you've got [20:16] this bacteria in your mouth and they [20:18] feed on that sugar. And as they feed on [20:20] that sugar, they release acid. Um, and [20:23] if that acid is left there, then it can [20:25] cause demineralization of your teeth. [20:27] and that demineralization will end up [20:29] with decay. [20:31] Okay. So, let's talk about the personal [20:35] oral microbiome. Um, is my oral [20:37] microbiome different from say Jack's [20:39] over there and from my girlfriends? [20:42] Yes. Massively. [20:43] Massively different. [20:44] Yes. Maybe massively I would say. Um, so [20:48] one of the issues that I used to have [20:50] was I was doing lots of oral microbiome [20:52] testing. Um, and I would have, you know, [20:55] let's say you and your girlfriend do an [20:57] oral microbiome test and both of you, I [20:59] would see your results and they would [21:00] come out pretty much the same because [21:02] we're only looking at certain bacteria. [21:04] We can't look at all 700. So, we would [21:06] look at the top 20 bacteria that cause [21:08] problems. So, I would look at both of [21:10] them and then I would look inside your [21:11] mouth and one of you, I don't know in [21:14] this case, had raging gum disease and [21:16] terrible, terrible oral health and the [21:19] other person would be completely fine. [21:20] So then I realized that actually it's [21:22] not just bacteria that causes disease or [21:25] problems, it's how your body responds to [21:27] that bacteria and the strains of [21:29] bacteria that you have as well. So for [21:31] every bacteria um there'll be multiple [21:34] strains and some of those strains can be [21:36] really aggressive and really horrible [21:37] for your mouth and other strains are [21:39] completely fine and are not going to [21:41] cause you any problems. So when I [21:43] developed my test, what we did is we [21:45] looked at strains. So we looked at the [21:46] strains of certain bacteria um and we [21:49] would be able to differentiate between [21:50] patients who had the really bad strains [21:52] and the really good strains. But then [21:54] also we looked at the ratio of good and [21:56] bad bacteria in someone's mouth. So [21:58] their diversity as well as their genetic [22:00] mutations and also their inflammation. [22:02] So when you put all of it together and [22:04] you it's like a puzzle piece then you [22:06] can actually have a better insight into [22:08] someone's oral health. So, I guess my [22:11] answer is that everyone's oral [22:13] microbiome is a little bit different, [22:14] but it's also how your body responds to [22:16] that microbiome and bacteria that really [22:18] dictates whether or not you're going to [22:20] have disease or problems. [22:21] So, you could be someone who takes care [22:23] of their teeth really, really well, but [22:24] still have a bad oral microbiome [22:27] relationship with the rest of your body [22:29] effectively. [22:30] Yeah. And I see it every day. And we [22:31] have a lot of patients who suffer from [22:33] terrible gum disease and they come to me [22:35] and they brush three times a day. [22:36] They've never touched a cigarette. They [22:38] have immaculate oral hygiene. They eat [22:41] very well, but they have terrible gum [22:43] disease. And for those patients, they [22:44] might have genetic mutations that [22:46] predispose them to gum disease and to [22:49] inflammation. So even the smallest [22:51] amount of bacteria, their body responds [22:53] in a very aggressive and inflammatory [22:56] destructive way, which can cause [22:57] disease. [22:58] When I was speaking to I think it was [22:59] Tim Spectre about the gut microbiome, he [23:01] was telling me that the gut microbiome [23:03] turns over, i.e. the bacteria dies every [23:06] couple of days or weeks or something. [23:09] How often does the oral microbiome die [23:14] turn over and why does that matter? [23:16] So, what's interesting or different [23:19] between the oral and gut microbiome? The [23:20] oral microbiome, if someone doesn't go [23:23] in there and mechanically disrupt the [23:25] bacteria and the plaque in your mouth, [23:28] then that bacteria can stay forever. So, [23:30] the gut, what happens is you've got [23:31] something called paristelis. got [23:33] movement. So the bacteria moves, it it [23:35] changes, it regenerates, there's [23:37] turnover in the mouth. So the teeth are [23:39] the only non-shedding surfaces in the [23:41] whole body. So that [23:42] non-shedding surfaces. [23:44] So imagine if you if you never had a [23:46] shower in your life. Uh you would still [23:49] selfwash because the skin cells would [23:51] shed. [23:52] Mhm. [23:53] But if you never brushed your teeth, [23:55] then your teeth are not shedding. [23:56] They're going to stay like that. So that [23:58] bacteria will just keep on growing and [24:00] growing and growing and growing and [24:02] you'll get this really thick plaque. So [24:05] that's why actually the oral microbiome [24:07] you need to mechanically remove that [24:09] bacteria and that's why brushing your [24:10] teeth is super important or um using the [24:13] correct toothpaste or etc. going and [24:15] seeing your hygienist because you need [24:17] to mechanically remove that bacteria [24:19] quite regularly. [24:21] Okay. And the the two ways I was reading [24:23] in your work it said that the two ways [24:24] that oral health impacts overall health [24:26] are by the spreading of bacteria and the [24:28] other sort of central issue is it causes [24:30] inflammation. [24:31] So on this point of spreading bacteria [24:34] I'm always concerned this is a bit of a [24:36] superstitious thing but anytime that I'm [24:38] sick I'm always like don't part of me is [24:40] like don't swallow because in my head I [24:42] think if I'm sick in my mouth or if I've [24:44] got um like a sore throat or something [24:46] I'm like if I swallow it the rest of my [24:48] body is going to get sick. It's super [24:50] super superstitious, but is there any [24:52] truth to any of this? [24:54] Um, so not from just being sick like a [24:56] common cold. And it's actually really [24:58] interesting. I had a patient yesterday [24:59] and bless him, he's very young, 7 years [25:01] old. Um, and he had exactly that same [25:05] mindset. He just randomly woke up one [25:07] day and he said, "This is kind of gross. [25:09] Why am I swallowing my saliva? There's [25:11] all these bad bugs and gross things in [25:13] my saliva and I'm swallowing it every [25:14] day and it's traveling to the rest of my [25:16] body at seven." And so what he ended up [25:20] doing was refusing to swallow his own [25:22] saliva. And so he would basically just [25:24] dribble and he would just wipe his the [25:27] saliva off with a sleeve or he'd carry a [25:29] towel with him and just wipe it. So [25:31] bless him, he had a big rash around his [25:32] his um his face. Um and it it was a bit [25:37] of a weird moment for me because I was [25:39] like, you're kind of right. Like I mean [25:41] it is a bit weird especially as a child [25:43] to sit there and think like yeah you've [25:45] got 700 different bacteria two billion [25:47] bacteria overall and then you're [25:49] swallowing it and it can travel [25:50] elsewhere to the rest of the body. So [25:52] yes in in short yes bacteria from your [25:55] mouth when you swallow it can travel [25:57] elsewhere to the rest of the body. [25:59] However a lot of the bacteria um dies. [26:02] So the acid in the stomach can kill a [26:05] lot of the bacteria. So it's only the [26:06] really really bad bacteria that are able [26:09] to survive and cause problems. And [26:10] that's why it's so important that you [26:12] have a good oral microbiome and you [26:13] balance it well. [26:14] And the other central way that it can [26:16] cause [26:18] negative impacts to your overall health [26:19] is via inflammation. What is the link [26:22] between inflammation and my my oral [26:24] microbiome? So it's uh something that we [26:28] call lowgrade chronic inflammation and [26:30] imagine so you've got this delicate [26:32] balance of bacteria in your mouth which [26:34] is your microbiome and we all have bad [26:36] bacteria in our mouths but most of us [26:39] hopefully have better levels or higher [26:42] levels of the good bacteria. So there's [26:44] always that balance and what happens in [26:46] an imbalanced oral microbiome is that [26:48] shift changes. So you get higher levels [26:50] of bad bacteria and you don't have [26:52] enough good bacteria. These bad bacteria [26:55] firstly yes they can travel elsewhere to [26:56] the rest of your body as you discussed. [26:58] The second is that they can release [27:00] inflammatory markers. So they basically [27:02] release inflammation and this [27:04] inflammation can travel from your mouth [27:06] to the rest of your body and contribute [27:08] to inflammation elsewhere. So for [27:10] example if you had rheumatoid arthritis [27:12] and then you had inflammation from your [27:14] gums that inflammation from your gums is [27:17] making your arthritis in your wrists [27:19] worse. So it's contributing to it. Now [27:22] what's also interesting and that's why [27:24] it's called lowgrade chronic [27:25] inflammation is often you wouldn't even [27:27] know that you have it. I have so many [27:29] patients who say oh you know my gums [27:31] bleed but that's normal. If your eye [27:33] bled or if your foot was bleeding every [27:36] day you would be worried and you would [27:38] think actually there's inflammation [27:40] here. There's a problem here. But so [27:42] many people have bleeding gums and they [27:43] don't understand that bleeding gums is a [27:46] sign. It's your gums screaming to you [27:47] saying that I have inflammation and that [27:49] inflammation can travel. And then the [27:52] third mechanism as well. So there's one [27:54] more is um it's damage to your blood [27:56] vessels. So again the same bad bacteria [27:58] in your mouth. It releases these [28:00] enzymes, these toxic enzymes and they [28:03] can travel through the rest of your body [28:04] through your blood vessels and they can [28:06] actually damage your blood vessels. So [28:08] these blood vessels are not able to [28:10] dilate and constrict as well as they [28:12] used to. [28:13] On that point of arthritis, I read a [28:15] stat which um I believe is true. I think [28:17] it actually came from some of your [28:18] research that said people with [28:19] rheumatoid arthritis are eight times [28:21] more likely to develop gum disease than [28:23] patients without rheumatoid arthritis. [28:26] Yes. [28:27] Which is shocking. [28:28] Yeah. So there's a really strong um [28:30] birectional relationship between [28:32] rheumatoid arthritis and gum disease. So [28:34] that means that if you have really bad [28:36] rheumatoid arthritis, you will have [28:38] pretty bad gum disease. And if you treat [28:40] your rheumatoid arthritis, your gum [28:42] disease will get better. and vice versa. [28:44] If you have if you treat the gum [28:46] disease, your rheumatoid arthritis will [28:47] get better. And that was actually one of [28:49] the um first patients that really got me [28:53] on my journey of the mouthbody [28:55] connection. So like yeah, I was doing [28:56] the saliva testing. I got it. You know, [28:58] I was like, "Okay, cool. We are [29:00] quantifying oral health. We're tracking [29:02] things." But even me, I wasn't really [29:06] fully sold on this whole mouthbody [29:08] connection, how our mouth is connected [29:09] to the rest of the body. So, I had a [29:11] patient who was sent to me by um her [29:13] functional medicine practitioner and she [29:16] had been seen by uh four or five [29:18] different practitioners. She had [29:20] terrible rheumatoid arthritis and she um [29:23] went to this final guy and he was the [29:25] first guy to ever ask her, "Have you [29:27] ever had your teeth checked? What's [29:28] happened?" And she said, "Oh, I've had a [29:30] few teeth taken out in the last year or [29:32] two, about six teeth, but you know, it's [29:34] just it is what it is." And he was like, [29:36] "I I don't think that's normal." So he [29:39] sent her to me and he was like, "Can you [29:40] do your saliva stuff that you do and see [29:42] if there's anything up going on there?" [29:44] And we did do a saliva test, we saw that [29:46] she had super high levels of [29:48] inflammation, of collagen breakdown, um [29:51] high levels of bad bacteria. And what [29:54] was the most important was that when I [29:56] treated her gum disease, she had [29:57] terrible gum disease and that's why she [29:59] was losing her teeth. When I treated the [30:01] gum disease properly and aggressively, [30:03] um, yes, her gums healed, but more [30:05] importantly, her rheumatoid arthritis [30:07] got better to the point where she was [30:09] actually able to get off steroids and [30:11] medication and be able to walk again. [30:14] Wow. [30:14] Yeah. [30:16] By treating her gum disease. [30:17] Yeah. And I think that, you know, [30:19] sometimes as a dentist, we treat a lot [30:22] of gum disease and we treat a lot of [30:23] things and we don't necessarily see the [30:26] systemic consequences because the [30:28] patient doesn't come back or you know um [30:31] or it's such a small impact that you [30:33] don't necessarily see it. But this was [30:35] the one time where I was like wow like [30:37] what we do is actually really really [30:40] insightful and really important. And you [30:42] mentioned alongside that um inflammation [30:44] also has an impact on cardiovascular [30:46] functioning and health. I believe it's [30:49] the case that cardiovascular disease is [30:51] the biggest killer in the world from [30:52] what I understand. Um so I was wondering [30:55] if if you knew any of the stats that [30:57] show the impact or the the increased [31:00] likelihood of me having a heart attack [31:01] or a stroke or something based on my [31:03] oral microbiome. [31:06] So um the research has shown that if you [31:08] have gum disease you are at a 20% higher [31:11] chance of high blood pressure. Um but [31:13] also they are now saying that up to 30 [31:16] to 40% of cardiac um issues in hospital [31:21] can be traced back to an oral bacteria [31:25] um causing problems in the heart valve. [31:27] Um so the reason for this connection so [31:30] yes inflammation but also going back to [31:33] that third mechanism I told you which [31:35] was about the vasoc constriction so the [31:37] blood vessels constricting and dilating. [31:40] So these toxic enzymes which are being [31:41] released by the bacteria they travel [31:43] through the blood um and they basically [31:46] stop the blood vessels from being able [31:48] to widen and lots of blood to travel to [31:51] the heart and also to constrict and that [31:53] also is um one of the biggest [31:55] connections with uh heart disease. [31:57] I found this stat which might well be [31:59] from your work or someone else's. It's [32:00] from the study called the association [32:01] between parodontitis and blood pressure [32:04] highlighted in systemic systemically [32:06] healthy individuals. [32:08] Not mine but okay. And it found that [32:10] people with gum disease were twice as [32:12] likely to have a heart attack and three [32:14] times as likely to have a stroke than [32:16] those without inflammatory gum disease, [32:18] which is absolutely staggering. [32:21] Yeah. And then another study also showed [32:23] that when you treated someone's gum [32:25] disease, their levels of CRP, and CRP is [32:28] an inflammatory marker that you can [32:30] check in your blood, the levels of CRP [32:32] significantly reduced. And for a lot of [32:34] patients who suffer from heart [32:36] conditions, they will get their CRP [32:37] quite regularly checked through blood [32:39] testing. [32:40] And so this is a way of reducing their [32:42] inflammation is just by having a a [32:43] simple hygiene. And I've even seen um [32:46] particularly in America, there's a lot [32:48] of um uh cardiac surgeons and um doctors [32:52] related to to heart health um who are [32:55] now actually working with dentists [32:58] because they understand that if they [32:59] work together, then they're going to [33:01] have far better results for their [33:02] patients. And this is this is that [33:05] swallowing thing we're talking about. [33:06] This is because you're swallowing that [33:07] bad bacteria. [33:08] Yeah. And your heart valve um imagine if [33:10] it's been it's faulty. Imagine you just [33:12] had surgery. I always think of it like [33:15] it's sticky. It's like velcro. So it's [33:17] really prone to infection and problems. [33:19] It's just like if you fell over and you [33:21] had a scab and you were rolling around [33:23] in mud all the time, you would get [33:25] bacteria going into that scab and [33:26] causing problems. There's the same thing [33:28] with your heart valves. [33:29] Doesn't the bacteria just travel on its [33:30] own anyway? Cuz I feel like it's in my [33:32] mouth. So I feel like it I don't know [33:34] these are living organisms don't they [33:35] just like find their way down even if I [33:37] don't swallow. [33:38] Yeah even through your blood um and also [33:41] through your gums as well. So you can [33:43] swallow your bacteria breathe it or it [33:46] can go through your blood. [33:47] At the start of this conversation we're [33:48] talking you mentioned the sort of [33:50] implications for your cardiovascular [33:51] system and one of the things you said [33:52] was erectile dysfunction and that was [33:55] slightly alarming to me as a man [33:57] um who's trying to stay away from [33:59] erectile dysfunction. What is what is [34:00] the research that supports this idea [34:03] that my oral microbiome can have an [34:04] impact on my erectile functioning? [34:08] So men who have periodontal disease are [34:10] 2.85 times more likely to suffer from [34:12] erectile dysfunction. [34:14] 2.8 times. [34:15] Yeah. [34:16] Is I'm pretty sure that's 280% isn't it? [34:18] Yeah. [34:19] Okay. So what is this perodontal [34:20] disease? [34:21] Gum disease. Okay. So uh it's kind of I [34:24] would say it's a bit of a spectrum. So [34:26] the early stages of perodontal disease [34:29] or gum disease is just gum inflammation. [34:31] So that's that patient who is brushing [34:33] their teeth, spits in the basin and sees [34:35] blood. So that's the you know the early [34:37] inflammation. If they don't get that [34:39] checked out and sorted that will just [34:40] continue and continue and continue to [34:43] what we call gum disease. Um and that's [34:45] where yes you've got inflammation but [34:47] actually you have really high levels of [34:49] bad bacteria now. And this bacteria is [34:51] essentially eating away the gums and [34:53] also your bone. And uh it's it's now [34:57] become irreversible. [34:58] I'm just going to have a swig of this [35:01] for your thought this [35:06] and then at the very end of the spectrum [35:08] is people who are losing their teeth [35:10] having really terrible gum infections [35:12] and all of these kind of mouthbody [35:14] connections that we're talking about. [35:16] Okay. And that can you just explain [35:19] again as if I'm 10 the how my how that [35:23] gum disease that parodontitis is it [35:24] called [35:25] has an impact on my penis I don't [35:27] understand like I don't understand the [35:28] link it makes all of my blood vessels [35:30] exactly [35:31] yes so it essentially stops your blood [35:33] vessels from dilating [35:35] and so you've got reduced blood flow to [35:37] your penis [35:38] okay [35:38] and therefore [35:41] doesn't work [35:41] okay so this is an emergency this stuff [35:43] this is really is important [35:44] that's the one statistic whenever I have [35:46] a and in the chair and he's like, "Oh, I [35:48] don't want to brush my teeth." I'm like [35:49] 2.85 times more likely to have erectile [35:51] dysfunction. They usually will go [35:52] straight to the bathroom to brush their [35:54] teeth. [35:54] The other thing, no, but it's true, but [35:56] also the other thing that I I read in [35:57] your research, which I found really [35:58] really um shocking is the link between [36:03] my oral health, my oral microbiome, and [36:06] cancer. [36:07] Yeah. [36:08] I was reading specifically about female [36:10] breast cancer, [36:11] um which I know is affects a lot of [36:13] women. um what is the link there between [36:15] breast cancer cancer generally and our [36:17] oral microbiome. [36:19] So this is um I would say some of the [36:21] newest emerging research that's coming [36:23] out. So with breast cancer um I didn't [36:26] know this before this research came out [36:28] but your breast has uh its own [36:30] microbiome. So that tissue within the [36:32] breast um different bacteria are able to [36:35] grow. And what they found was that in [36:37] women who had breast cancer, they had [36:40] high levels of certain oral bacteria in [36:42] their breast microbiome. So the oral [36:44] bacteria is called fusobacterium [36:46] nucleatum. And they compared the breast [36:49] microbiomes of patients who didn't have [36:52] breast cancer versus those who had [36:53] breast cancer. [36:54] Sorry, what's an oral what's a breast [36:56] microbiome? [36:57] Just the collection of bacteria in your [36:58] breast. [36:59] Okay. [36:59] Yeah. Um I didn't even know there was a [37:01] microbiome in your breast either, but [37:03] apparently so. And um so when they [37:05] compared a healthy um woman uh her [37:09] breasts to a woman who had breast [37:11] cancer, the woman who had breast cancer [37:13] had very high levels of the specific [37:15] oral bacteria called fusobacterium [37:17] nucleotum in their breast. Um there's [37:20] also been research on colurectal cancer. [37:23] Um and actually Apple News came out with [37:26] something couple of months ago which was [37:28] nice to see them kind of just spreading [37:30] the word. But what they found was that [37:32] in patients who had colarctal cancer um [37:36] more than 50% of them had the the exact [37:39] same oral bacteria from the breast [37:40] cancer study that fusobacterium [37:42] nucleotum in the colons and what they [37:45] found was that oral bacteria uh made the [37:49] cancer more aggressive and harder to [37:51] treat as well. [37:53] I was reading about a study in mice um [37:55] that linked that oral bacteria to tumor [37:58] growth. Mhm. [37:59] Are you familiar with that study? [38:01] Yes. And it's that specific oral [38:02] bacteria. So the fusacter nucleotum [38:05] which has been shown to accelerate tumor [38:07] growth um within mice but also um for [38:10] colorectal cancer and breast cancer as [38:12] well. [38:14] And what's your belief there? I know [38:15] this research is fairly new but do you [38:17] think there is a a causal relationship a [38:19] significant causal relationship between [38:20] the health of our oral microbiome and [38:22] our probability of developing some form [38:24] of cancer? [38:25] I wouldn't yet say causal. I think that [38:30] for most cancers it is multiffactorial [38:34] and there are a lot of things that can [38:37] impact whether or not you get the cancer [38:39] and how aggressive the cancer is. Um I [38:42] do think that oral health and some [38:44] specific oral bacteria um are risk [38:47] factors and can definitely increase the [38:50] um aggression of those cancers or even [38:53] the initiation of them. Um there's also [38:55] been research and I think I'm waiting [38:57] for the research to be published on what [39:00] they're doing is they've created a [39:01] antibiotic which only kills that oral [39:04] bacteria that I was talking about. So [39:06] fusobacterium nucleiatum and they are [39:08] going to be issuing that uh antibiotic [39:11] to those patients who have the colctal [39:13] cancer which has the oral bacteria to [39:16] see whether or not it slows down their [39:18] progression or improves their their [39:20] prognosis. So if I see those results and [39:22] it shows it, then there's for sure a [39:25] strong positive link between the two. [39:27] But for now, I would say that it's [39:29] multiffactorial and it's definitely a [39:30] risk factor. [39:31] That oral bacteria that you're [39:33] describing that you called it fuzo [39:35] bacterium. [39:35] Yeah. [39:36] What is it that causes that? Is it [39:38] something that I'm eating? Is it a [39:39] lifestyle choice I'm making? [39:41] Uh multiple things. Poor oral hygiene. [39:44] Um some of us genetically will have [39:46] higher levels of it. Um it's what we [39:48] eat. It's who we're kissing. It's what [39:50] we're breathing in. [39:51] Does my girlfriend have it? [39:54] So, we would have to see. Um, but it's [39:56] uh and that's the thing. That's the [39:57] beauty of being able to test these [39:59] things now is that you can actually see [40:00] and also what's it's strange is that [40:03] green tea um you know something so [40:05] simple is extremely effective at killing [40:08] fusoacterium nucleotum. So, it's just [40:10] knowing those types of things, being [40:11] able to do the test, knowing the right [40:13] treatment plans and recommendations [40:15] based from that. We know green tea is [40:17] good for us and now we can really [40:19] understand why. [40:20] Okay, that's interesting. You you have [40:22] actually tested Jack over there, right? [40:23] And you said to me before we started [40:24] recording that he's got a ton of that [40:26] fuzo bacterium. [40:28] Uh yes, he does. Yeah. [40:29] And it's really getting out of control. [40:31] That's what you said. [40:31] Really badly out of control. Yeah. So, [40:33] I've um [40:36] I've given him a big vat of green tea as [40:38] a gift. [40:39] Green tea? [40:40] Yes, [40:41] green tea. [40:43] This guy's going to edit that out. This [40:44] is the problem. [40:48] me up. [40:51] Green tea. [40:51] Yeah, [40:52] that's good for my own microbiome. [40:53] Yeah, really good. Stains, but really [40:55] good. Um, it's anti-inflammatory. Um, it [40:59] helps with what we call oxidative [41:00] stress. So, this is um, basically stress [41:03] of for the body. Um, and it's [41:05] antibacterial. So, it actually is very [41:07] effective at killing fusobacterium [41:09] nuclei. [41:10] What is your opinion of the impact that [41:12] coffee has on my oral microbiome? I'm [41:15] slightly biased because I love coffee. [41:17] Okay. [41:18] But there is no negative impact of [41:21] coffee on the oral microbiome directly. [41:25] Um coffee does dry your mouth out. Um [41:28] and so you have reduced saliva and that [41:30] can actually cause problems for the oral [41:33] microbiome. So the saliva is super [41:36] important in your mouth. It provides all [41:38] of the food, the proteins, everything [41:41] for the bacteria in your mouth. So, it's [41:42] kind of like this delivery service. Your [41:45] delivery roots traveling around [41:46] providing all the food and bacteria um [41:49] sorry, food to the bacteria and that's [41:51] what keeps the good bacteria alive and [41:53] happy. So, when you have a dry mouth, [41:55] let's say you're drinking lots of coffee [41:57] or you're very nervous or you are on [41:59] anti-depressants for example, um which [42:01] are a big one, then you just don't have [42:03] as much saliva. So you those bacteria [42:06] don't have as much food and those [42:08] bacteria die and then you get bad [42:10] bacteria growing in replacement. [42:12] What about tea? We're a nation of tea [42:14] drinkers in the UK. [42:16] Um similar. So it also does dry your [42:18] mouth. Not as bad as coffee, but [42:19] otherwise no problems other than [42:21] staining. [42:22] What about if I put loads of sugar in [42:23] it? Cuz a lot of people put a lot of [42:24] sugar. [42:25] Okay. Yeah. No, no, no. Never. No. No. [42:26] So actually sugar in your tea is even [42:29] worse than you having a biscuit for [42:32] example. Um so because the sugar [42:34] dissolves in your hot tea and the tea is [42:37] hot when you drink it um it can actually [42:39] cause more problems. Uh another thing [42:42] with sugar is um I have a sweet tooth. I [42:45] love sugar. But it's about how you eat [42:46] your sugar. So let's say if you have [42:48] your hot tea with five lumps of sugar in [42:51] there and you're sipping it over an hour [42:53] or two, that's where you start to see a [42:55] lot of problems. So actually you need to [42:57] be having a sugar attack. So just all [43:00] the sugar in one go. And that way your [43:02] mouth has all the sugar in one go and [43:04] it's able to neutralize the saliva and [43:06] get back to a good state as quickly as [43:08] possible. Every time you sip your your [43:11] tea with sugar, what happens is that the [43:13] saliva has to go from acidic back to [43:16] neutral, acidic, back to neutral, [43:17] acidic, and then it starts to just not [43:19] work properly and the saliva just stays [43:21] acidic and that's where you start to see [43:23] decay. [43:23] So you want to just down the tea, [43:25] down the tea or I don't know if you're a [43:27] M&M guy, have all your M&M's in one go. [43:30] Don't snack on M&M's every 10 minutes. [43:32] What about other drinks like, I don't [43:33] know, you know, Coca-Cas and these other [43:35] sort of fizzy drinks that might have [43:38] artificial sweeteners in things like [43:39] that. [43:40] So, they're not as bad as your natural [43:43] sugars. Um, but for example, something [43:46] like your Coke or or Fanta or whatever, [43:48] it's also um very acidic. Um, and it can [43:52] actually cause erosion as well. So this [43:54] is essentially where the outer layer of [43:56] your tooth, so the enamel is just worn [43:58] away from having lots and lots of these [44:00] fizzy drinks. [44:01] Okay. So that it's not going to cause [44:02] decay in the same way, but it might [44:04] change the acidic balance which then [44:06] decays my tooth, which makes me more [44:08] susceptible to when I eat sugar to [44:10] having a problem. Okay, got [44:12] so going back to what we were talking [44:13] about the the implications of an oral [44:15] microbiome and the rest of my body, [44:16] brain health is one thing that I was [44:17] really curious about. Um, we've had lots [44:19] of conversations on this show about [44:21] Alzheimer's and dementia and just [44:23] general sort of optimal cognitive [44:25] performance as I age. Something I'm [44:26] thinking a lot about. I want to have a [44:28] sharp brain. It's quite important [44:29] because of what I do. Um, so is there a [44:31] link between my oral microbiome and my [44:33] cognitive and brain health? [44:35] Yes. Um so if we look at actually just [44:39] the the occurrence of Alzheimer's um and [44:42] gum disease or oral health, a lot of [44:45] research has shown that um if you have [44:49] gum disease for more than 10 years, you [44:52] have a 70% increased chance of [44:54] developing Alzheimer's. So that was a [44:56] study that was done on over 20,000 [44:58] people and they followed them for 20 [45:01] years and they saw okay if you had gum [45:03] disease um at baseline whether or not [45:06] you get Alzheimer's at 10 years or 20 [45:08] years so a 70% increased chance of it um [45:11] they've also done a lot of research [45:13] where uh they've been looking at oral [45:16] bacteria and what they found was that [45:18] there are certain oral bacteria so uh [45:21] one called p gingeralis that's one of [45:23] the worst oral bacteria I would say out [45:25] of all of them. So this penjavalis is [45:28] able to travel from your mouth to your [45:30] brain. It's only it's quite close by [45:32] anyway. And what's unique about this [45:34] bacteria is it's able to cross the [45:36] barrier between uh in your brain. So the [45:39] bloodb brain barrier um and it releases [45:41] these toxic enzymes. So these enzymes [45:43] are called gingipes and they're imagined [45:45] these like horrible firefighter things [45:48] and they can break down neurons. They [45:50] can break down um a lot of brain tissue. [45:53] And so when they looked at the cerebral [45:55] spinal fluid and the brain fluid or [45:57] tissue of Alzheimer's sufferers, they [45:59] found that 97% of them had these toxic [46:03] enzymes, these ginger pains in their [46:05] brains compared to zero for the patients [46:08] who did not have Alzheimer's. So this [46:10] is, you know, the first study shows, [46:12] yes, there's some sort of correlation, [46:13] but there's a lot of other risk factors. [46:15] The second one, which is looking at your [46:17] ginger pains, is showing that there's [46:18] definitely a strong causitive factor um [46:21] between the two. And then another study [46:24] which was very interesting was um [46:26] looking at cognitive cognitive decline. [46:29] So okay fine you have Alzheimer's [46:31] unfortunately um is it is it too late [46:34] should you stop brushing your teeth or [46:36] what's the point? And so what they did [46:38] was they had uh patients um who had [46:40] Alzheimer's and they checked their [46:42] cognitive function and they also checked [46:44] their oral health. And then uh six [46:46] months later they reviewed them and they [46:49] found that the patients who had gum [46:50] disease had a much more rapid cognitive [46:53] decline than those patients who didn't [46:55] have gum disease. So again, it is still [46:57] important if you do get Alzheimer's that [46:59] you maintain your oral health, that you [47:01] have someone help you brush your teeth [47:03] because your cognitive decline um will [47:06] be faster. [47:07] How do they unpick that from other [47:09] causal factors that might be going on [47:11] like bad food choices? Because in my [47:14] head I was thinking, well, if someone's [47:15] drinking sugary, fizzy drinks every day, [47:19] they're more likely to have gum disease, [47:22] but maybe also that the chemicals within [47:24] that fizzy drink are impacting their [47:26] chances of dementia. Maybe they're also [47:28] someone that has an unhealthy lifestyle. [47:30] Maybe they're more sedentary. If they're [47:31] eating bad things, maybe they're more [47:33] sedentary. And maybe it's that that's [47:34] causing the rapid cognitive decline [47:37] versus the gum disease itself. Is it [47:39] possible to untangle all of this? [47:40] I mean, it is very difficult. I think [47:42] that for those types of things, you [47:44] either, you're right, diet, lifestyle is [47:47] super important and we know that [47:48] Alzheimer's is again multiffactorial. Um [47:51] I think it's really about the quantity [47:53] of patients that they check. So they [47:55] need to be looking at a huge number of [47:58] patients and they did um to check [48:00] whether or not there is a strong [48:02] correlation between them. Um, also going [48:06] back to the ginger pain study, so the [48:08] one about the bacteria that shows it [48:10] doesn't it's not diet or lifestyle or or [48:13] nutrition. It is a specific oral [48:15] bacteria that has traveled to the brain [48:17] and released these enzymes which are [48:18] then breaking down neurons. So there [48:21] there's definitely a strong positive um [48:24] effect. [48:24] That is um fascinating. It's really [48:26] really fascinating because dementia and [48:28] Alzheimer's still seem to be a bit of a [48:29] mystery. it is and and I work um with a [48:34] team for Alzheimer's and what they've [48:36] done similar to what you were saying is [48:38] that they've kind of separated all of [48:39] the the causes of Alzheimer's that we [48:42] know um or the risk factors and [48:44] thankfully they've put oral health as [48:46] one of them as well and I think from all [48:49] of the other risk factors so uh you know [48:51] for example if you have uh the genetic [48:54] mutations you got the APO4 or any of [48:57] those mutations that's you can't change [48:58] that unfortunately some of us have [49:00] mutations which means that we are at a [49:02] much higher risk of suff of getting [49:04] Alzheimer's in the future. But something [49:07] like that oral bacteria p gingalis and [49:09] those gingi pains you can get rid of p [49:11] ging javalis really easily again if you [49:13] tested it you can even test for gingi [49:15] pains um and then you can get rid of the [49:17] bacteria before it starts causing [49:19] problems. [49:21] The test that you offer does it test for [49:22] gingi pains? [49:23] It does. Yeah. So, we're the only ones [49:25] um on the market who do because that was [49:27] something that I thought was super [49:29] important. What's the point in us [49:31] telling you that you have a bacteria if [49:33] we can't tell you that that bacteria is [49:35] being really bad in your mouth and [49:37] causing a lot of problems? [49:38] And people think I'm joking, but you [49:40] have actually tested several members of [49:41] my team, including myself. So, I am [49:43] actually going to find out the results [49:44] today. Um on the subject matter of the [49:46] brain, is there a link between my mental [49:48] health, depression, anxiety, and my oral [49:53] microbiome? [49:54] So again, there's been a lot of [49:55] research. Um I think it's difficult for [49:58] something like mental health and um and [50:03] gum disease, which you know, with the [50:04] chicken and the egg, which one came [50:05] first? Um because one of the issues is [50:09] if you have a decline in your mental [50:11] health, you are less likely to take care [50:12] of your oral health. um and therefore [50:15] that can exacerbate issues. So there has [50:17] been a lot of research to show that you [50:19] know [50:20] uh there's a correlation between poor [50:22] mental health and poor oral health. But [50:24] in my personal opinion that causitive [50:27] connection is not there yet. Um there's [50:30] also been some research with things like [50:31] schizophrenia, but again it's the jury [50:35] still in my opinion. [50:37] Are you able to tell the state of [50:39] someone's mental health by looking at [50:40] their oral microbiome in your view? [50:43] um you can know if something's up. Like [50:46] for example, I I had a patient [50:48] relatively recently. I've been treating [50:50] her for five, six years now, and I know [50:52] that she takes good care of her her [50:54] teeth. She she takes good care of [50:55] herself. And a few weeks ago, she came [50:58] in and she was not taking care of her [51:01] gums or her teeth at all. Everything was [51:02] an absolute mess in there. And um so I [51:05] did pull her aside and I was like, [51:06] "What's wrong?" Like something's [51:08] happened here. And I think it is quite a [51:10] big um sign for a lot of people. It's [51:13] the first thing that they kind of let go [51:14] of is their oral health. [51:17] And is that because of, you know, they [51:19] start certain self soothing behaviors [51:21] because they're stressed in other parts [51:22] of their life. So if they're having a [51:24] bad time in their relationship or work [51:25] and they're stressed, they might start [51:27] eating sugar more or [51:29] or just not brushing, [51:30] smoking or drinking more. Okay. [51:31] Or just not brushing. Like with this [51:33] woman, she just wasn't brushing her [51:34] teeth anymore. Another thing that we can [51:36] also see, I mean it's kind of a bit on a [51:39] tangent, but also um eating disorders as [51:42] well. So things like bulimia um or even [51:45] sometimes anorexia, you can see in the [51:47] mouth. So there's a lot of times where [51:48] we'll see young teenagers um and I'll [51:51] know that they are bulimic because they [51:53] have certain issues in their mouth which [51:55] they shouldn't have and that again is a [51:57] telltale sign. [51:58] Is that because the stomach acid is [51:59] coming through their mouth? [52:01] Yeah. So they get a lot of erosion on [52:02] the on their teeth and then in some [52:04] cases you can also get these marks on [52:06] the roof of your mouth. So if they're [52:07] trying to force themselves to to vomit [52:09] then you can see that. Um and that's [52:12] something that you know you have to pull [52:13] the patient aside or tell their mother [52:15] and explain that to them as well. [52:17] And is there a relationship between [52:19] stress and my oral health? So if I'm [52:20] more stressed and my cortisol levels are [52:22] higher, is that going to make everything [52:24] in my mouth worse? [52:25] Yes. [52:26] Even outside of the lifestyle choices I [52:28] might make in such a state. [52:29] Yes. just that stress will increase your [52:32] inflammatory markers, your inflammation. [52:34] Um, it also will dry your mouth out and [52:36] all of those things will be linked. Um, [52:39] uh, we do a lot of testing at my clinic [52:42] and so one of the tests that we look at [52:44] is collagen breakdown. So, um, we have [52:47] lots of different types of collagen all [52:48] over our bodies and our gums are made up [52:51] of a certain collagen. So we look at an [52:53] enzyme called ammpn and this enzyme is [52:56] responsible for breaking down that [52:58] specific collagen. Um so we test the [53:01] coll that enzyme all the time with our [53:03] patients. It's a really nice way of [53:05] knowing like um whether or not someone's [53:07] about to have gum disease. Um how much [53:09] collagen breakdown is happening from a [53:11] biomolelecular level. So I had a woman [53:14] very healthy, always been fine. Um and [53:17] then she had her collagen breakdown [53:18] tested and her levels were through the [53:21] roof. her gums looked fine. She didn't [53:23] look like she had any problems, but I've [53:25] never seen such a high level in my life. [53:27] And so, you know, I'm trying to think of [53:29] what could be causing it. All of that. [53:31] And she had lost her baby a couple of [53:33] days before. And that type of intense [53:37] stress on someone's body can have so [53:39] many effects and impacts on the rest of [53:42] your body. Um, and that was one of them. [53:44] When we retested her six months later, [53:46] she was back to normal again. But you [53:48] can see even your mouth, you know, [53:50] stress can really impact you. [53:52] On this subject, I was thinking about I [53:54] mentioned Jame James Nester earlier who [53:56] was telling me about the research of um [53:58] how the the mouth has changed shape [54:00] because of the foods we're eating and [54:02] how that that's caused a bunch of [54:03] downstream implications for us. One of [54:05] the also one of the other things he also [54:08] mentioned was about mouth breathing and [54:10] nose breathing. Yes. [54:11] And there's a lot of people that have [54:13] become incredibly interested in whether [54:14] we should be breathing through our [54:15] mouths or our nose. And I was wondering [54:17] if you had a perspective on that. Um, [54:21] and also the other thing that he [54:22] mentioned to me was that there's a link [54:24] between mouth breathing and things like [54:27] ADHD. What is your point of view? [54:30] Uh, completely agree with all of that. [54:32] So actually my sister, she is an [54:34] orthodontist. Um so she works at our [54:37] clinic and um we run it together with [54:40] our mother and um she is very very hot [54:42] on um mouth breathing. And what she um [54:47] mainly does is she basically tries to [54:50] stop children in particular from [54:51] breathing with their mouths open. And [54:53] what she has found is that most of her [54:55] patients um who come to her um are mouth [54:58] breathers. They often have some sort of [55:00] um ADHD. they have or some sort of [55:03] attention deficit. Um they are uh bed [55:07] wetters. They grind their teeth a lot of [55:09] the time. Um and they have a whole [55:11] cascade of other problems and uh she can [55:14] treat it then and it's relatively easy. [55:17] She would argue that it's very [55:18] difficult, but to me I think it's easy. [55:20] I'm like, "Yeah, there we go. You can do [55:21] what you do." Um and because the the [55:23] jaws of a child are very malleable, so [55:25] they haven't fully solidified, so you [55:27] can still move things. You can um get [55:29] the teeth to meet. So if you get the [55:30] teeth to meet correctly then uh the [55:34] child won't want to breathe with their [55:35] mouth open. The annoying thing is is [55:37] that uh a lot of adults are mouth [55:39] breathers because their teeth do not [55:41] meet correctly or their jaws are in the [55:43] incorrect position and uh at that point [55:46] it is quite difficult to move the jaws [55:48] into the correct position or to get the [55:50] teeth to close in a way so that the lips [55:53] are at rest and you breathe with your [55:55] nose instead of your mouth. But again, I [55:57] see those types of patients because they [55:59] all come to me with a lot of other [56:01] problems. So again, same thing. A lot of [56:03] them have uh a lot of them have suffered [56:05] from long COVID. A lot of them have [56:07] inflammatory conditions. Um are always [56:10] tired. They a lot of them chronic [56:12] fatigue. It you know there's a lot of [56:15] connections now uh between mouth [56:17] breathing and those types of issues as [56:18] well. [56:19] Is there a link between the health of my [56:21] oral microbiome and whether I breathe [56:23] through my nose or mouth? cuz James was [56:24] explaining to me that the nose is [56:26] effectively like a a filter system. [56:28] Yeah. [56:29] There's a certain temperature in there. [56:30] Yeah. [56:31] Um there's like sinuses and stuff which [56:33] are have some kind of mucus which helps [56:35] to catch bacteria. So if I'm breathing [56:37] through my mouth, am I more likely to [56:38] have unhealthy oral microbiome? [56:41] 100%. So exactly the same thing. You're [56:43] you're you've got a filter in your nose [56:45] and so it will stop a lot of bad things [56:47] from coming through. But the mouth uh [56:50] there is no filter. I mean you breathe [56:51] it in, it goes straight into your lungs. [56:53] So, there's no way of stopping anything. [56:55] A lot of people now are starting to [56:57] mouth tape. Um, and that's become kind [56:59] of trendy and cool. Um, it's not the [57:02] easiest thing to do. If it seems a bit [57:05] weird to tape your mouth at night time, [57:08] um, but for anyone who's worried that [57:10] they breathe with their mouth open, [57:12] mouth taping, in my opinion, is a really [57:14] nice way of just like testing it out and [57:16] seeing whether or not you do breathe [57:17] with your mouth open because you'll do [57:19] some mouth taping and you can see [57:20] whether or not you sleep better. So, if [57:22] you have a wearable, you can see, "Oh, [57:23] wow. My oxygen levels are so much [57:25] better. I had such a deep sleep." And if [57:27] that's the case, you might be more [57:29] inclined to straighten your teeth or [57:31] sort out the reason that you're [57:33] breathing with your mouth open. [57:35] I I uh took notes of a study which kind [57:38] of is interconnected to the point we [57:39] were making about mouth brea breathing [57:41] which said in a six-year study of 11,000 [57:43] children. It was found that children who [57:45] suffered from sleep disordered breathing [57:47] were 50 to 90% more likely to develop [57:50] ADHD like symptoms than were normal [57:53] breathers who breathe through their nose [57:55] correctly which is absolutely [57:57] staggering. 50 to 90% more likely to [58:00] suffer from ADHD like symptoms just [58:03] because they breathe through their mouth [58:05] at night and disordered breathing. [58:07] And it's it's mainly to do with also [58:08] oxygen being delivered to your brain, [58:11] right? [58:11] So there's not as much good oxygen um [58:14] like real rich oxygen, filtered oxygen [58:17] traveling to the brain and so that's [58:19] basically not allowing your brain to [58:21] function as well. [58:22] You mentioned kissing earlier on. [58:24] Yes. [58:24] Um I'm still supposed to kiss my [58:26] partner, right? [58:27] Yes. I hope you do many times. [58:29] You you said if I kiss her more than 11 [58:31] times a day or something then our oral [58:33] microbiomes synchronize in some way. [58:36] Yeah. So there is um passage of bacteria [58:39] from you to her and her to you. Um they [58:42] have also shown that uh for example they [58:44] did a study where one uh partner chewed [58:47] lots and lots of probiotics or like good [58:49] bacteria and then had a super long [58:52] smooch with their partner and actually [58:55] was able to transfer nearly 60 or 70% of [58:58] that good bacteria into their partner. [59:01] So it's not necessarily longlasting. I [59:03] wouldn't say that um you know if you [59:05] kiss someone once on a night out that [59:07] you are going to terribly impact your [59:09] microbiome. it's fine. You can go and [59:11] kiss, but it's more for long-term [59:13] partners. If you're kissing regularly [59:14] and for a long time, then yes, your [59:16] microbiomes will start to um be quite [59:19] similar. Um, another factor as well is [59:21] that obviously your lifestyles are [59:22] probably pretty similar. You're probably [59:24] using the same toothpaste, eating the [59:26] same food. So, it's difficult to fully [59:28] put it on just kissing, but yeah. [59:30] What about oral sex and the implications [59:33] that will have? So, if we're if me and [59:35] my partner are doing oral sex on each [59:37] other, is that going to impact our oral [59:38] microbiome? Yes. So, actually there's [59:41] been a few case reports which have shown [59:43] um uh there's one in particular and I [59:46] had a patient as well who had this a [59:48] woman who um had a new partner and she [59:52] liked to perform oral sex on him and [59:55] then she came to me because she was [59:57] complaining of very inflamed gums and [59:59] she was getting gingivitis [60:01] and you know it's not something I really [60:03] ask like I'm not going to be like how's [60:04] your how's your sex life going these [60:06] days like so I didn't ask it but she [60:07] kept on coming back to me No, my gums [60:09] are still inflamed. No, my gums are [60:11] still inflamed. And then she asked, she [60:12] was like, "Is it maybe because I have a [60:13] new partner?" I was like, "Okay, maybe [60:15] you guys are kissing a lot." And she was [60:16] like, "No, no, no, no." And and then she [60:18] explained to me. Um, and then I was [60:19] like, "Okay, fine. Why don't you go and [60:21] test and ask him whether or not he has [60:23] any issues." Um, and it turns out that [60:25] he was having recurrent urinary [60:27] infections. And so, actually, they were [60:30] transferring bacteria and she was having [60:32] inflammation in her gums because she was [60:35] Yeah. performing her oral sex. So, yeah, [60:38] there is transfer. Again, I wouldn't be [60:40] scared and say never do it. Um, I once [60:43] made an ex-boyfriend do an oral [60:45] microbiome test uh just to check and [60:47] just to make sure everything was okay. [60:49] You made him do it. [60:50] Yeah. I don't It's not a It's not a um a [60:54] prerequisite anymore, but it was at the [60:56] time. I was like, "H, let me see. Let me [60:59] You must think that when you meet [61:00] people. You must think, God, I wonder [61:01] what their own microbiome is saying like [61:03] in a romantic context cuz you know the [61:05] significance of it." [61:06] Yeah. I think it's a, you know, I spend [61:07] a lot of time and energy making sure my [61:09] oral microbiome is very nice and [61:11] balanced. So, I wouldn't want anyone [61:12] messing that up for me. So, it's [61:14] important. [61:15] Are you in a relationship now? [61:16] Yes, I am. [61:16] Have you tested their oral microbiome? [61:18] I've been trying to, but he won't let [61:20] me. [61:21] You've asked him. [61:22] Yeah, of course I have. [61:23] And what did he say? Mind your own [61:24] business. [61:24] But I did give him an oral microbiome [61:27] test. So, hopefully he will just use it. [61:28] I said, "You can even use a fake name. I [61:30] don't care. I don't I'm not going to [61:31] test. I'm not going to check it. I just [61:33] want you to do the test for me. [61:35] For for you? [61:36] For me? Yeah. [61:37] And what's his what's his rebuttal? He's [61:39] like, I don't [61:40] He was like, what happens if you break [61:41] up with me if I have a really imbalanced [61:43] oral microbiome? And I was like, I hope [61:44] that our relationship is stronger than [61:46] just your oral microbiome. But there's [61:48] ways to fix it. And that's the beauty of [61:49] the oral microbiome is that it's [61:51] actually pretty easy to to fix and to [61:53] change. [61:54] If his results came back and he had a [61:56] terrible oral microbiome, one of the [61:57] worst you've ever seen. [61:58] Yeah. [61:59] Are you less likely to kiss him that [62:01] day? that day. Yes. [62:03] There you go. Don't do the test, my [62:05] friend. [62:05] No, no, no. Don't do the test that day. [62:07] Yes. [62:08] There's no upside to him doing this [62:09] test. I completely understand. [62:10] And then I would go and creep into his [62:12] bathroom and change all of his oral [62:14] products. This is what he's scared [62:15] about. [62:15] Personalize everything for him. And then [62:17] you've done that already. [62:18] I already have. He tests everything out [62:21] for me as well because I get a lot of [62:22] products sent to me. So, I'm always [62:23] getting him to to try things out for me [62:25] as well. [62:26] Okay. So, no if they've got um [62:29] issues down there. [62:30] Yeah. Okay. [62:32] And we don't really know if they've got [62:33] issues down there unless they admit it [62:34] or do some kind of test. [62:36] Yeah. Yeah. [62:37] Okay. What about fertility? Is there a [62:39] link between our oral health and our [62:40] fertility? [62:42] Yes. Um so if we look at men to start [62:46] with um there was a study done and they [62:50] found so they looked at a group of [62:52] subfertile men. So, men who um weren't [62:55] able to conceive with their partners and [62:57] they checked all of their mouths and [62:58] they found that over 90% of these men [63:01] had some sort of oral infection or [63:04] dental disease of some sort going on. [63:06] They split the group into two. Half the [63:08] group had the uh treatment that was [63:10] needed. So, I don't know if they had gum [63:12] disease or decay. They they got it fixed [63:15] and the other half were left to their [63:16] own devices. Um after eight months there [63:20] was a 70% improvement um in their [63:23] success for pregnancy. The men who'd had [63:26] their oral infection sorted um and they [63:28] had a much better improvement in their [63:30] sperm quality and motility as well. [63:33] And what did they do to those men in [63:34] that group where they saw the [63:36] significant improvement? So, for [63:38] example, if the man had um gum disease, [63:41] they would treat it with hygiene or if [63:44] they had an infected tooth, maybe they [63:46] would take it out or do a root canal or [63:48] etc. They would just have to treat that [63:49] infection. So, I speak a lot about gum [63:52] disease all the time, but actually [63:53] there's so many other oral diseases like [63:55] decay um or tooth a types of things that [63:59] can also contribute inflammation and [64:01] problems. In that study, 6 months after [64:03] that, their sperm had improved by 20%. [64:06] And after 8 months, 50% of their wives [64:08] were pregnant. [64:09] Yes. [64:10] That is staggering. [64:11] Yeah. [64:12] What about women though? Is is there a [64:14] similar sort of result as it relates to [64:16] women's fertility? [64:17] Yes. So, um research has also found that [64:20] if a woman has gum disease, um she is [64:23] less likely to ovulate. Um and also [64:26] she's going to have uh issues with [64:28] conception. So they found that women [64:30] with gum disease it takes them two [64:31] months longer to conceive versus a woman [64:34] who doesn't have gum disease. Um but [64:36] once the woman has conceived um the [64:39] issue is still not over. She still has [64:40] to maintain her gums. So firstly a lot [64:43] of women will have um pregnancy [64:45] gingivitis. So this is basically super [64:47] inflamed puffy gums because of all the [64:49] hormones. Um and so they should be going [64:52] very regularly to see their hygienist. [64:54] Um but also what the research has found [64:56] is that women who are pregnant and have [64:58] gum disease are at a much higher risk of [65:00] preterm birth so premature uh babies low [65:04] birth weight um and also preclampsia as [65:06] well. So they did a study in Malawi um [65:09] it was on 10,000 women. So Malawi has [65:11] the highest rate of preterm birth in the [65:14] world at just about I think [65:17] just under 20%. Um, and preterm birth is [65:21] a a big issue for for governments, for [65:24] hospitals. It's really expensive. You [65:26] need to keep the woman and the child in [65:28] the hospital for a lot longer, but also [65:30] that child will have a whole myriad of [65:32] problems afterwards as well. So, [65:34] weirdly, Wrigley's um the sugar the [65:37] chewing gum company sponsored this uh [65:40] study. They went to Malawi. They had [65:42] these 10,000 women. They split them up [65:43] into two. 5,000 of those women uh were [65:46] given sugar-free chewing gum, [65:47] toothbrush, and some toothpaste. And the [65:49] other half were left alone. And they [65:52] found that there was a 20% improvement [65:55] um or 20% sorry, reduction in preterm [65:58] birth in the woman who'd had the [65:59] sugar-free chewing gum compared to the [66:01] woman who hadn't had it. So something so [66:04] cheap and so easy like chewing gum was [66:07] able to actually reduce the risk of [66:08] preterm birth for these women. [66:10] How and why? So, if you look into the [66:13] research a little bit more, um you're [66:15] going to get your chewing gum now. [66:17] Yes. [66:18] Um so, sugar-free chewing gum um has [66:22] been shown to um stimulate your saliva. [66:25] So, it helps with what we were talking [66:26] about earlier, saliva is super [66:28] important, um and it provides all the [66:29] good food for uh your bacteria. Um but [66:32] then also, if it's sugar-free, um let's [66:34] say it's using xylitol, that's naturally [66:36] antibacterial, so it's killing a lot of [66:38] the bacteria in the mouth. And what they [66:40] found is that there are certain oral [66:42] bacteria that can travel down to the [66:44] placenta um and can also uh cause [66:47] problems there and essentially um [66:50] increase the chance of preterm birth. [66:52] You sufficiently convinced me that [66:53] saliva is an important thing and I [66:55] actually did one of your tests. Let me [66:57] go grab the results. [66:58] Okay. [67:00] Every single time you eat, you have an [67:02] opportunity to improve your health. [67:03] That's why I love Zoe because it helps [67:05] me to make the smartest food choices for [67:08] my body. As you guys probably know, Zoe [67:10] is a sponsor of my podcast. I'm also an [67:12] investor in the company, which is [67:13] important to say. I invested in the [67:15] company because Zoe combines my health [67:17] data with their worldclass science. [67:19] Using these two things, Zoe guides me to [67:22] better health every single time I make a [67:24] food choice and eat, which means I have [67:25] more energy, better sleep, better mood, [67:28] and I'm less hungry. And the best part [67:29] about Zoey is that it's backed by their [67:31] recent clinical trial, something called [67:33] the method study, which is the gold [67:35] standard of scientific research. I [67:37] started Zoey just over a year ago now [67:39] and I've been able to track my progress [67:41] week after week so I can learn how to be [67:43] even smarter the week after. And if you [67:45] haven't joined Zoey yet, I'm going to [67:47] give you 10% off when you join Zoey [67:49] today. Just use the code Steven10 at [67:52] checkout. So many of you have asked me [67:53] for a bloody code for Zoe and here is [67:55] your opportunity. Steven 10 at checkout. [67:57] There may not be another one. [68:00] And here are [68:03] the results. Okay. [68:04] I've not actually seen them yet, so this [68:06] is exciting. Um, I'll give them to you [68:07] so you can explain them to me. [68:09] Okay. [68:09] Is that okay? So, this is the test that [68:11] I did, right? [68:12] Yes, you did. Yeah. [68:16] And the test I did contains [68:21] this little kit that basically in the [68:23] middle of the office one day, someone [68:24] came up to me and said, "Steve, can you [68:26] spit in this?" And I said, "Sure." [68:29] Yeah. [68:29] And then they took my spit away. Um, it [68:32] turns out it was upon request from you. [68:35] Yes, exactly. I wanted your saliva. [68:37] Yeah. Which is [68:37] just to check to make sure if I could do [68:39] this interview, [68:39] right? Okay. [68:41] So, this is the test that I did. I spat [68:43] in this little thing, sent it off back [68:45] to you. You ran the test. How long does [68:47] it take to do this test? [68:48] Uh, it would probably take you about 2 [68:50] minutes to do spe yourself and then you [68:52] get the results three to four weeks [68:54] later. [68:55] What did you find out from doing my [68:57] test? [68:58] Well, okay, [68:59] let's go through your results. So um we [69:02] found that you have quite a diverse [69:04] microbiome. So that means that you have [69:06] a nice ratio of good bacteria versus bad [69:10] bacteria and this has been compared to [69:12] healthy and diseased subjects. So you [69:14] are really right on the top of the bell [69:16] curve. So very good with that. So happy. [69:19] Um then we predict your [69:21] diverse is better. [69:22] Uh arguably yes. Yeah. [69:23] Okay. Um then what we have is we've [69:26] created this algorithm that predicts [69:28] your risk of certain um issues or [69:30] diseases in the mouth. So those are [69:32] things like bad breath, gum disease, um [69:35] decay and general inflammation. [69:37] So your risk of bad breath was low. You [69:40] didn't have a high risk for that. Gum [69:43] disease was medium. So slight maybe [69:45] there's a bit of inflammation going on [69:47] there. Your risk for uh decay was also [69:50] medium. And your risk for general [69:52] inflammation. So this is inflammation [69:54] throughout the rest of your body. Um was [69:56] quite low. Um and then if we zoom in, we [70:00] then look at your good bacteria. So [70:02] we're also quite unique because we [70:05] thought that it was unfair that a lot of [70:06] tests don't look at the good stuff. So [70:09] we look at all of the bacteria which has [70:10] been shown to be the most beneficial in [70:12] the microbiome. So for you, you had [70:14] pretty much high to very high levels of [70:17] uh good bacteria, which is great. Uh no [70:20] problems with that. And then we look at [70:22] bad bacteria. So we actually uh look at [70:26] about 500 different bacteria, but then [70:28] we zoom into the top 20 bad ones which [70:31] are really associated with things like [70:33] gum disease, decay, bad breath. So for [70:35] you, out of all the bacteria that we [70:37] looked at, you only had quite high [70:39] levels of one bacteria which was bad for [70:41] you. Um and so this bacteria is very [70:44] strongly associated with basically a lot [70:47] of buildup of um plaque in your mouth. [70:50] So, having not looked in your mouth, I [70:53] have no idea about your dental health or [70:55] anything like that. I would assume that [70:57] basically um you're a bit overdue on a [70:59] hygiene. Maybe maybe there's a lot of [71:00] plaque buildup going on um from that [71:03] result. But the rest of the bad [71:05] bacteria, so all of these ones we're [71:06] talking about, [71:07] the erectile dysfunction, [71:08] your erectile dysfunction ones fine. Um [71:10] your pen javalis is fine, you know, [71:13] fucleatum, those ones were actually uh [71:15] very good. Um then also on top of that [71:19] going back to the Alzheimer's. So we [71:21] look at those virolence factors [71:22] associated with punjavalis and you had [71:24] none of those virilence factors which is [71:26] also really good. [71:28] Okay. [71:29] Then we look at your genetic mutations. [71:31] So uh we've identified about 10 [71:34] different genetic mutations which [71:35] increase your risk of decay and gum [71:37] disease. So uh for the decay out of the [71:41] five genetic mutations we looked at four [71:43] out of five of them you hatch. So that [71:45] means that you and maybe you you have [71:48] stopped it, but you are at a higher [71:50] chance of having a sweet tooth, of [71:52] having more acidic saliva. On top of [71:55] that, it might be that you if you're [71:57] stressed out or you're really unhappy, [71:59] some people will run to the casino, [72:02] others will run to the bottle. And for [72:04] you, you might actually be someone who [72:05] goes and has a chocolate bar and [72:07] actually enjoys sugar. [72:08] No comment. [72:08] Um, on top of that, [72:10] make your business. [72:12] Let's say you've had your sugar because [72:13] you are stressed out or whatever. You [72:16] also have been shown to have a genetic [72:18] mutation which means that your taste [72:20] perception is lower. So you need two [72:22] bars of chocolate, not just one. [72:24] No comment [72:25] to make you feel [72:26] That's the end of this podcast. [72:27] That's the end of this episode. I'll [72:28] give you my card. [72:32] Close your document. How dare you? [72:35] No, I mean it all it all squares with [72:37] reality. So please do keep going. [72:39] Um so that's your decay. uh situation in [72:42] terms of gum disease. Again, we look at [72:45] um certain mutations. So, there are some [72:47] mutations that can triple your risk of [72:49] gum disease. Um they can increase the [72:52] amount of inflammation that you release [72:53] from your mouth. So imagine um you there [72:57] are some people who even the smallest [72:58] amounts of bacteria they might have [73:00] great hygiene they have a few small bad [73:02] bacteria in their mouths they have [73:04] mutations which means that they respond [73:05] in a very hyperinflammatory and very [73:08] aggressive way and they will be at a [73:10] very high chance of gum disease. So in [73:12] your case um you had one mutation and I [73:17] would say out of all of the mutations [73:19] for gum disease it was the best one. So [73:21] it basically means that you have um [73:24] genetically you're more predisposed to [73:26] bacteria collecting around your gums. [73:28] Okay? [73:28] So you might be someone who actually [73:30] needs to go really regularly for a [73:32] hygiene and it's kind of a bit annoying [73:33] because you keep on getting build up or [73:35] they keep telling you to come back [73:37] because actually genetically you have [73:39] that in your saliva. [73:40] Mhm. [73:41] Um then afterwards we give you [73:43] personalized recommendations. So, we [73:46] tell you based on um everything that [73:48] we've seen, the bacteria, your [73:49] mutations, what your input from the [73:51] questionnaire, we tell you what [73:52] toothbrush would be good for you, what [73:54] supplements you should be taking, what [73:56] uh toothpaste, floss, um everything [74:00] basically, even chew sugar-free gum, all [74:02] of those types of things to um improve [74:04] your oral health and rebalance your [74:06] microbiome. [74:07] And you could tell all of that just from [74:08] me spitting in a tube once. [74:10] Yes. And then at the very end, we have a [74:13] list of all of the detected organisms. [74:15] So, like I said, we look at the top 20, [74:17] which we know are really bad for you, [74:18] but actually sometimes in some patients [74:20] will have like weird bacteria, really [74:23] high levels of weird bacteria. So, I had [74:25] one patient, she had really bad breath [74:27] and her gums were kind of okay, her [74:29] teeth were okay, there were no problems, [74:31] but she was like, I don't know what's [74:32] going on. So, she did the saliva test [74:34] and she had 40% of her oral microbiome [74:37] was made out of one bacteria. So, uh I [74:40] was searching this bacteria. I was like, [74:42] I've never heard of this bacteria [74:43] before. It is extremely prevalent in [74:45] dogs. So then I get back to her. I'm [74:48] like, "Do you have any dogs?" And she [74:49] was like, "Yeah, yeah, I have four four [74:50] or five dogs at home." And I was like, [74:51] "Do you kiss your dogs?" She was like, [74:53] "Yeah, of course I do. Like they're my [74:54] they're my babies." So she was kissing [74:56] her dogs and she was getting transfer of [74:58] bacteria from her dogs into her mouth [75:00] and that was what was making up her [75:01] whole microbiome. [75:02] And that was giving her bad breath. [75:04] Yeah. Yeah. [75:04] So what I did was I gave her um a [75:08] treatment recommendation [75:10] and no I gave all of her dogs I said you [75:12] need to take the specific um it's not [75:14] medication it's like a supplement so it [75:16] basically stops uh like buildup of [75:19] plaque in dogs teeth. So I was like your [75:21] dogs have gum disease basically so they [75:23] need to be treated if you wants to get [75:25] better. And after everyone got treated [75:27] her bad breath went and so did her dogs [75:30] as well. Uh, so are dog owners more [75:33] likely to have bad breath? [75:35] If you are smooching your dog then, [75:37] yeah, kind of. And your dog has gum [75:39] disease. [75:39] If you're kissing your dog. [75:40] Yeah. [75:40] Okay. Interesting. So, what are the very [75:45] having seen my results, but generally [75:47] from seeing the thousands and thousands [75:48] of results that you've seen? [75:49] Yeah. What are some of the the easiest [75:52] things that I could do to help correct [75:55] that situation and have perfect oral [75:57] health and a perfect oral microbiome? [76:00] So, um, what we've done is if you were [76:03] to do the test, you would have all of [76:04] the personalized recommendations for [76:06] you. So, we tell you to have green tea, [76:08] to have honey, all of those types of [76:09] things which have been shown um through [76:12] research to benefit your microbiome in [76:15] your case specifically. But if we were [76:18] just talking about someone who hasn't [76:19] done the microbiome test and wants to [76:21] just make sure that they have as [76:23] balanced of a microbiome as possible, um [76:26] diet is obviously very important. So, [76:28] what we're talking about that sugar [76:29] attack, making sure that you only have [76:31] one sugar attack a day. Um you're not [76:33] having sugar consistently because it [76:35] does alter your saliva um pH. Uh the [76:38] type of toothpaste that you're using. I [76:40] like to keep it simple. You don't need [76:41] to we don't need to make things super [76:43] complicated. You don't have to spend [76:44] that much money. Having the right [76:46] toothpaste, right toothbrush, and the [76:48] right floss is honestly as much as is [76:51] the most necessary thing that you need. [76:54] Okay. So, in terms of brushing though, [76:56] you give some sort of practical advice [76:58] around when we should brush. [77:00] Mhm. [77:00] What is that? And is there any time [77:01] where I shouldn't brush my teeth? [77:03] Uh, you should never brush straight [77:05] after anything acidic or sugary. So, [77:07] what you end up doing is is grinding the [77:11] sugar or the acid into your teeth. [77:14] So, actually, you should wait 30 minutes [77:16] until you brush your teeth. [77:17] That's interesting because when I eat [77:18] something sugary, I feel like I need to [77:20] brush my teeth to get rid of it. [77:21] Yeah. No. No. So, you want to wait 30 [77:24] minutes. So, instead, you can chew some [77:26] sugar-free gum or um there are lots of [77:29] pastals that we use. So, like I use like [77:30] chewable mints um and you can chew one [77:33] of those and it will actually neutralize [77:35] your saliva really quickly so that you [77:37] don't have that acid causing the [77:40] demineralization. And do I spit or do I [77:43] rinse after I've brushed my teeth? [77:45] Spit. So, you should never rinse your [77:46] mouth out with water after you brush [77:48] your teeth. So, brush, brush, brush, [77:50] spit into the basin, and that's it. [77:52] Reason being, again, going back to my [77:54] sunscreen analogy. Um, imagine you spend [77:56] 2 minutes putting all this lovely [77:58] sunscreen all over your skin to then [78:00] just go and have a shower right before [78:02] you go into the sun. So, with the [78:04] toothpaste, you you spend 2 minutes [78:06] putting all of that on your teeth. And [78:08] then if you rinse it, then you're [78:09] actually removing all of that goodness [78:11] from your teeth and gums, and it's kind [78:13] of like you haven't done anything. [78:15] Toothbrushes. [78:16] Yes. [78:17] Which toothbrush should I use? This one [78:19] or an electric one? [78:21] Um, I generally prefer an electric [78:23] toothbrush. [78:24] Um, usually they kind of do the work for [78:27] you. So, it just means that patients [78:30] have better oral health because most [78:32] people don't know how to brush their [78:33] teeth properly. Actually, we're never [78:35] really taught or trained or we get [78:36] taught by our parents. Our parents don't [78:38] really know. They've been taught by [78:39] their parents. So, a lot of people don't [78:41] actually know how to brush their teeth. [78:42] Number one. Number two, we often don't [78:45] brush for as long as we think that we [78:46] are. So, we're meant to brush for 2 [78:48] minutes. The average is 20 to 30 [78:51] seconds. And we think that we're [78:52] brushing for 2 minutes, but we're not. [78:54] So, with an electric toothbrush, it [78:55] times you and then also a pressure [78:57] sensor. So, the electric toothbrush [78:58] often will have a pressure sensor which [79:00] will show you whether or not you're [79:01] brushing too hard or you're brushing at [79:03] the right pressure and that will reduce [79:05] your chance of recession. [79:07] Can you show me on one of those tooth [79:08] models in front of you the area of the [79:11] mouth and teeth that people most often [79:14] overlook? [79:15] Yes. [79:16] Can I have your teeth? [79:19] So, I would say the area that people [79:21] usually um struggle with the most is the [79:24] insides of their very back bottom teeth. [79:26] So inside where next to my tongue [79:28] basically. Yeah. Just near your tongue [79:30] basically. What a lot of people will do [79:32] is they'll kind of they'll go on the [79:34] inside and they brush their teeth like [79:35] this. Okay. Whereas actually you want to [79:37] get your elbow up and you want to brush [79:40] a lot more at like a a 90° angle when [79:42] you're getting there. [79:43] It looks like you're brushing the gums a [79:44] little bit. [79:44] A little bit. Yeah. So you actually do [79:46] want to brush the gums a little bit. And [79:47] then when we're on the outsides of the [79:49] teeth, uh we want to kind of brush at a [79:51] 30° angle. So rotational movements and [79:54] at a 30° angle. So, not straight like a [79:56] 90°, but kind of towards the gum margin. [79:59] And by doing circular mo movements, [80:01] we're essentially kind of massaging the [80:03] gums and getting rid of the bacteria [80:04] from under the gum and then flicking it [80:06] out. [80:07] Okay. [80:08] Yeah. So, just like that. And then I [80:10] always tell everyone it's really [80:11] important to kind of have um a method [80:14] behind your toothbrushing. So, don't go [80:15] like brush and then go there and then up [80:17] there and you know cuz you'll never [80:19] brush properly. Um, so always start, [80:21] let's say, on the left hand side, go do [80:23] all the outsides and then do all the [80:24] biting surfaces and then do all the [80:26] insides and then do the same on the top [80:28] teeth as well. [80:29] And that model there, you've got another [80:31] model in front of you which is like a [80:32] see-through model. What does that show [80:34] us? [80:35] Um, so this is to show you um what an [80:38] implant looks like. A lot of people [80:39] don't know what implants look like um [80:41] and how it looks like if it was within [80:42] your jaw. [80:43] Also what all the roots look like. And [80:45] then also if you look on the other side, [80:47] you can see um this tooth which has the [80:49] black within it. [80:50] Yeah. [80:51] Um and it's got like a red bubble at the [80:52] root of it. So this is a tooth that's [80:55] had a root canal done to it and has an [80:57] infection at the root of that tooth. So [80:58] that's an abscess. Um and a lot of [81:00] people don't actually know what that [81:02] looks like. Um they only feel toothache, [81:04] but this is what toothache is actually [81:06] in their jaw. [81:07] When our teeth get teeths, is that the [81:09] right word? Is that a plural? When our [81:11] tooths, what's the plural of teeth? It's [81:13] teeth. Is it teeth? Yeah. [81:14] Yeah. When our teeth get stained, [81:16] yes, [81:16] what we often do is we'll take some sort [81:18] of whitening toothpaste or we'll go to a [81:20] a dentist or a hygienist or something [81:22] and ask them to whiten our teeth. [81:23] Now, I've always been a bit scared of [81:25] that because there must be a cost to [81:28] this whitening industry. Should we be [81:30] whitening our teeth? Is there any [81:32] healthy way to whiten our teeth? [81:34] Yes. Um, so you've got two different [81:38] types of staining. One which is [81:39] extrinsic. So that's basically your [81:41] coffee, your tea, your smoking. super [81:43] easy to get rid of. Um you just have to [81:45] go to your hygienist and get a hygiene [81:47] done and they'll get rid of the stains [81:48] um pretty quickly. Um or you can try a [81:51] whitening toothpaste. Be very careful [81:53] with a lot of those whitening toothpaste [81:54] because they can be quite abrasive and [81:57] damage the enamel actually. So it's kind [81:59] of like exfoliating your teeth, but your [82:01] teeth don't grow back. So if you keep on [82:03] exfoliating and and getting rid of that [82:05] surface layer of enamel over a long [82:07] amount of time, that can be quite uh an [82:09] issue and quite problematic. [82:10] You get sensitive teeth. Yeah, sensitive [82:12] teeth and then the underlying um tooth [82:14] will start to shine through and that's [82:16] quite yellow. So, you actually start [82:17] ending up doing the the opposite of what [82:19] you wanted to do. Um then whitening. So, [82:22] you could you should do that [82:23] professionally. Um don't go and buy some [82:26] over the counter online thing. Um [82:28] because a lot of the time either they [82:30] don't have the the right percentages and [82:32] they can actually damage the teeth and [82:34] the gums uh really badly. So, you want [82:37] to get that done professionally. um if [82:39] you get it done by a good brand and even [82:41] within the professional world there are [82:43] some whitening um products out there [82:45] which are really bad for the teeth and [82:47] others which are actually really good [82:48] for the teeth. So we use one in [82:50] particular um it's called a niton and uh [82:53] the whitening for one day is the [82:56] equivalent of having a Coca-Cola. Um so [82:59] thinking about it I mean I'm sure [83:01] everyone has had one Coca-Cola in their [83:02] life. Having a Coca-Cola every day for [83:05] let's say five or six days is okay in [83:07] the grand scheme of things. is not going [83:09] to massively damage your your teeth at [83:10] all. [83:11] Okay. So, there is safe ways to do it. [83:13] Okay, good. And is there any way to [83:14] remove plaque yourself without having to [83:16] go to a dental hygienist? [83:18] Um, so you can try a water flosser. Um, [83:20] I've just bought one of those things, [83:21] but it doesn't feel powerful enough cuz [83:23] when I go to the hygienist, I don't know [83:25] what they're using, but it like it like [83:27] it's so strong. [83:29] Yeah. [83:29] That it like blasts my mouth off. My [83:31] mouth feels so different after. [83:33] Yeah. [83:33] And I wanted to know if I could buy one [83:34] of those for my home, [83:36] but I think it's a little bit dangerous. [83:37] Um well the reason I think that the [83:39] water flossers are not that high [83:41] intensity is because people can um [83:43] damage their teeth if they don't use it [83:45] correctly. So kind of no there are some [83:48] supplements that you can take to reduce [83:50] the amount of plaque that builds up um [83:53] and that actually does work quite [83:55] effectively. [83:56] I mean what are you there are two more [83:57] there there's a couple more things there [83:58] that you have in your pile that we not [84:00] talked about. [84:00] These are probiotics. [84:01] Okay. [84:02] So going back to our microbiome uh [84:04] probiotics are basically good bacteria. [84:07] So, um, not everyone needs them, but a [84:09] probiotic, uh, essentially will, uh, put [84:12] good bacteria into the microbiome, and [84:14] if it's got the right environment to [84:16] live in, then it will continue to grow [84:18] there. Basically, [84:18] if you're eating the right things, [84:20] Exactly. If you're eating the right [84:21] things, you've got prebiotics, you're, [84:22] you know, all of those types of things, [84:24] then, then this will be really [84:25] effective. So, these are two different [84:26] options. This is a mouthwash. Um and [84:29] again on the microbiome test that we've [84:31] created or Alice one um we look at all [84:34] the levels of good bacteria and then [84:35] we'll recommend a probiotic based on [84:38] what good bacteria you are missing. So a [84:40] lot of us are actually genetically we've [84:42] been born without certain good bacteria [84:45] in our microbiomes and so this is really [84:47] lovely to supplement them. So this is um [84:49] it's a mouthwash but it's in a powder [84:51] form. So, you take a teaspoon, you mix [84:53] it with some water, and that activates [84:56] the probiotic, and then you rinse it [84:58] around, um, and you swallow it. So, it's [85:00] a kind of a twoin one for your gut. This [85:02] is a pill, so it's a tablet. You chew [85:04] it, um, and then you can swallow it. So, [85:06] this is again, this is super easy, too. [85:08] Um, and and I love these as well. Very [85:10] easy to use. [85:12] Victoria, what's the most important [85:14] thing that we haven't talked about today [85:15] that we should have talked about today? [85:17] Uh the only thing that I think you [85:20] haven't mentioned that your viewers [85:21] might benefit from is the use of straws. [85:23] Straws are very very important to to use [85:26] um for sugar and also for acid. So [85:29] drinking through a straw actually helps [85:30] you bypass um all of your teeth. So if [85:33] you're having something acidic or really [85:35] sugary or even something staining, then [85:38] it bypasses the teeth and goes straight [85:39] to back of your throat so you can [85:41] swallow it. Um so this helps reduces [85:43] your chance of decay of tooth wear and [85:45] also staining as well. But specifically [85:47] if it's bad for you because you I'm sure [85:49] there's some things which are good for [85:50] the oral microbiome that you do want to [85:52] be in the mouth. [85:53] Yes. Yeah. Yeah. So if you're taking [85:54] your probiotics or whatever then of [85:55] course those are great. Um like for [85:57] example um you know I'm human. I like a [86:00] nice Coca-Cola once in a while and I'll [86:02] drink it through a straw. Um or if I [86:04] have alcohol I'll also drink that [86:06] through a straw as long as it's not [86:07] wine. But [86:08] about smoking and vaping. [86:11] Um so yeah smoking and vaping. Neither [86:13] of them are good for the oral [86:15] microbiome. Um it goes back to um dry [86:19] mouth. So smoking will dry your mouth [86:21] out and then you don't have the saliva [86:22] and the saliva can't do what it wants [86:24] to. It stops um vascularization. So it [86:27] stops blood flow to your mouth. And so a [86:30] lot of uh smokers actually will not have [86:33] bleeding gums. That doesn't mean that [86:34] they don't have gum disease, but because [86:37] they um are smoking so much, the blood [86:39] vessels are already really tight and [86:41] constricted from the nicotine. Um so [86:43] they don't ever get bleeding gums even [86:45] though they have gum disease. Um and [86:48] then the third thing is that actually we [86:49] know that smoking is very strongly [86:51] associated one of the biggest risk [86:52] factors for gum disease. [86:54] If someone's now curious about their own [86:57] microbiome and the work that you're [86:59] doing what is the sort of easiest entry [87:02] point to learn more to get themselves [87:05] checked or to I don't know to resolve [87:07] some of the issues that are causal or a [87:10] consequence of having an unhealthy [87:11] microbiome. Where where do they start? [87:12] How do they find you? [87:14] We have a clinic in central London [87:16] called the Health Society. Um we opened [87:18] about a year and a half ago now. And our [87:20] aim was to put their mouth back into the [87:23] body to explain to patients exactly [87:25] what's going on in their mouth. And we [87:27] can do that through microbiome testing, [87:29] other saliva tests. Um we look at your [87:32] blood glucose levels, your vitamin D [87:33] levels. We've got packages. We have an [87:35] infrared sauna. We have a nutritionist. [87:37] And the idea is that we're working all [87:38] together because one of the issues I was [87:41] seeing was that patients, they want to [87:43] understand what's going on in their [87:45] mouth and they want to optimize it, but [87:47] they don't understand a lot of what [87:49] dentistry is all about. We used to live [87:52] in a world where the dentist would say, [87:53] "Okay, you need two fillings and you've [87:55] got gum disease and you're not brushing [87:56] your teeth." And that was the end of it. [87:58] And you would just listen to them and [87:59] you get your work done. But now we are [88:01] trying to essentially decode dentistry [88:05] and explain it in a way that patients [88:07] can understand. So I would say I'm [88:08] biased but come over, come to the [88:10] clinic, we can explain everything. Um or [88:12] you can do an oral microbiome test and [88:14] you can actually understand yourself [88:16] what bacteria, what genetic mutations [88:18] you have, what inflammation you have, [88:19] what products you should start using and [88:21] then based on that decide on what [88:23] dentist you want to go to for any [88:25] treatment if needed. [88:26] What if I'm in Australia or Canada or [88:28] New Zealand or America? what can I do? [88:30] Um, so we're actually rolling out the [88:31] oral microbiome test to all of those [88:33] countries. Um, so you can actually buy [88:35] at the moment uh through that. Uh, you'd [88:38] have to email us, but otherwise that, [88:40] you know, I'm not the only one. There [88:41] are other people who are doing this type [88:43] of dentistry um, and are thinking in [88:46] this type of way. So, you would have to [88:48] do a little bit of research, but um, I [88:50] guess maybe follow me on Instagram and I [88:52] can give some top tips. I'll I'll link [88:54] all your your website, your social [88:56] channels below, and if anyone wants to [88:57] send you an email, you might get a [88:58] couple of emails warning you now. Um, so [89:02] you got to be careful what you wish for, [89:03] but but I'll I'll put all those details [89:05] below. Um, we have a closing tradition [89:07] on this podcast where the last guest [89:08] leaves a question for the next guest, [89:10] not knowing who they're leaving it for. [89:12] Okay. [89:12] And the question that's been left for [89:14] you is, what is the most important [89:17] relationship in your life and why? [89:21] Um [89:22] this is going to cause you problems. [89:24] Yeah, I know. So [89:26] um I would say um my mother I think that [89:30] is the most important relationship for [89:33] uh me. I think she um has been uh one of [89:37] my biggest mentors. She's been my [89:39] biggest cheerleader, my supporter. Um [89:41] she's hard on us, but that has led to me [89:45] being the person that I am. Um, and I [89:47] think that if I don't have a good [89:49] relationship with her, um, then I can't [89:52] have a good relationship with other [89:54] people. She's taught me respect. She's [89:55] taught me how to, you know, handle [89:57] myself around people. Um, so yeah, I [90:01] guess, uh, big up to my mom. [90:02] Is she Is she Iranian? [90:04] She is. Yeah, [90:04] she's Iranian. Yeah. And your father? [90:07] He is French American. [90:08] French American. And if we sit here in [90:11] 10 years time, what are you hoping the [90:13] world looks like as it relates to the [90:14] oral microbiome, people's understanding [90:16] of it, the the regulations? What are you [90:18] hoping for? If you could wave a wand. [90:20] I am hoping that um the mouth is put [90:24] back into the body in the sense that [90:26] dentistry and medicine are fully [90:27] integrated within each other. So you can [90:29] go to your dentist and you can get a [90:31] saliva test and that could flag up [90:33] issues with your heart or diabetes and [90:36] you will go and see your diabetist. Um [90:39] and we link everything together. Uh also [90:42] my other dream is that people start [90:44] testing their saliva and they understand [90:46] that you know blood is not the only way [90:48] that we can understand things that are [90:49] going on within our body. [90:52] Dr. Victoria Samson, thank you so much. [90:54] Uh, I find this so unbelievably [90:55] fascinating in part because I've never [90:58] heard about any of this stuff before. [90:59] And I I do this job, you know, I've done [91:01] it quite a few times now. So, I've [91:02] spoken to a lot of health experts that [91:04] talk about the brain or I don't know, [91:06] infertility or um the gut microbiome, [91:09] but never one that looks at the body and [91:11] our overall picture of health through [91:13] the front door or the lens of our oral [91:16] microbiome. And so, it's really really [91:17] inspired me. And I think sometimes on [91:19] this podcast, I just love having these [91:20] conversations because sometimes it you [91:22] just need a little bit more information [91:23] about the importance of something to [91:26] make even a small change in your life. [91:28] And as it relates to our microbiomes, [91:30] our oral health, um our brain health, [91:32] and all of these things, even a small [91:34] change can have a big downstream impact [91:37] when we're talking about areas of our [91:38] health where things compound over time [91:41] and can either compound for us or [91:43] against us. And so, thank you so much [91:44] for doing the work that you do and [91:46] shining a light on this. work has been [91:47] really seinal in sort of driving the [91:49] conversation but also turning the lights [91:50] on to to the state and importance of our [91:53] oral health and I'm sure that if we sit [91:56] here in 10 years time you would have [91:58] impacted many many many millions of [92:00] people um and their overall picture of [92:02] health through the lens of the oral [92:04] microbiome because of the work you're [92:05] doing and the message you're putting out [92:06] there and that is quite something. So [92:08] congratulations well done and thank you. [92:10] Thank you so much. Thanks. [92:14] probably shouldn't be sharing this yet, [92:16] but you are our Diary of SEO community. [92:18] So, I wanted to give you a small first [92:20] look at a product that we're about to [92:22] launch exclusively. This is the 1% [92:24] diary. If you know me, you'll know that [92:27] one of the most uttered phrases in the [92:28] walls of my office is the 1% mindset. It [92:32] is a philosophy, a mindset, and a habit [92:34] that has absolutely changed my life. And [92:36] if you ask me, it is the reason that [92:38] this podcast has grown in the way that [92:40] it has. By understanding the power of [92:43] compounding 1%s, you can absolutely [92:45] change your outcomes in your life. It [92:47] isn't about drastic transformations or [92:49] quick wins. It's about the small [92:52] consistent actions that have a lasting [92:55] change in your outcomes. So 2 years ago, [92:57] we started the process of creating this [92:59] beautiful diary. And it's truly [93:00] beautiful. Inside there's lots of [93:01] pictures, lots of inspiration and [93:03] motivation as well, some interactive [93:06] elements. And the purpose of this diary [93:07] is to help you identify, stay focused [93:10] on, develop consistency with the 1%s [93:13] that will ultimately change your life. [93:15] We have a limited number of these 1% [93:17] diaries. And if you want to do this with [93:18] me, then join our waiting list. I can't [93:20] guarantee all of you that join the [93:21] waiting list will be able to get one, [93:23] but if you join now, you have a higher [93:24] chance. The waiting list can be found at [93:26] the diary.com. I'll link it below, but [93:29] that is the diary.com. [93:32] [Music] [93:35] Heat. Heat. N. [93:36] [Music] [93:52] [Music]